EECP of Chicago - Physician's guide to EECP

Rarely in the practice of medicine is there as much excitement as when a new and truly innovative treatment is introduced which expands your ability to manage your most difficult and debilitated patients. Enhanced external counterpulsation (EECP^®), now approved by HCFA and Medicare for the treatment of advanced angina pectoris, represents just such a remarkable innovation.

Click here for an online RealVideo^® presentation brought to you by EECP of Chicago.
Requires RealPlayer G2™, installed as a browser plugin—free version available for download from the link at the bottom of this page.

We are now able to extend and improve the lives of patients with coronary heart disease via a slew of surgical and percutaneous revascularization techniques and a burgeoning pharmacopoeia of anti-anginal medications. But this success has created a new class of patients, patients who have been revascularized numerous times and who require two, three or four anti-anginal drugs, and who still are plagued by life limiting (class II, III or IV) angina pectoris. It is for these patients that EECP^® was developed, studied and proven efficacious.
EECP^®is not as new as it is innovative. EECP^® is actually just an external, non-invasive form of intra-aortic balloon pumping (IABP), a treatment modality used daily in critical care units for patients with unstable angina or cardiogenic shock. As you may know, the IABP, once inserted into the descending thoracic aorta, is a 40 cc helium filled balloon which rapidly inflates and deflates timed with the onset of cardiac diastole and systole to dramatically reduce cardiac workload while improving diastolic coronary blood flow. EECP^® consists of inflatable cuffs wrapped around a patient's calves and lower and upper thighs, which rapidly inflate and deflate timed precisely to cardiac diastole and systole similarly decreasing cardiac workload and improving coronary blood flow.
The recently published double-blinded, randomized, placebo controlled MUST-EECP study has proven that late stage, maximally treated patients with lifestyle-limiting angina are significantly improved by EECP^® treatment. Furthermore, this reduction in angina frequency and severity was sustained in most patients one year later!
The exact mechanism of sustained angina relief with EECP^® is presently unknown. The growing body of published data, however, suggests that EECP^® stimulates collateral vessel development. Myocardial perfusion (thallium) scans performed both before and after a course of EECP^® therapy showed enhanced myocardial perfusion post-therapy. Very recent studies also show a significant increase in circulating levels of certain vascular growth factors (PDGF and VGEF).
EECP^® is not meant to be a replacement for revascularization techniques or standard medical therapy. It is indicated for use in patients with lifestyle-limiting angina who are no longer candidates for additional revascularization and whose medical regimen has been maximized. EECP^® is absolutely contraindicated in patients with significant valvular aortic insufficiency, severe arterial insufficiency of the lower extremities, or active thrombophlebitis of the legs. EECP^® is most effective in patients with stable cardiac rhythms. Patients with rapid atrial fibrillation or uncontrolled ectopy do not achieve adequate diastolic augmentation.
For a more detailed discussion on EECP^®, please take a few minutes to view our online video presentation.