What is Enhanced External Counterpulsation?

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  • Written By: wiseGEEK Writer
  • Edited By: O. Wallace
  • Last Modified Date: 08 January 2019
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Enhanced external counterpulsation (EECP) is fast becoming an accepted treatment for some patients who suffer from conditions like angina (severe chest pains) as a result of various types of cardiac disease. While the procedure may be “new” to the layperson, a lot of studies exist on differing forms of this treatment, and the matter has been discussed, researched, and tried in numerous settings since the 1950s. As practiced today, EECP is a means of stimulating new blood vessel growth surrounding the heart, via a method of compressing the legs and buttocks in specific rhythm with heart activity; this new growth has been called a surgery free way to effect bypass.

Heart surgery definitely takes less time, and equating enhanced external counterpulsation with bypass may be overstating things a little. Yet there is a growing body of evidence that undergoing this treatment may be extremely helpful. It could prove especially useful for those who are not good candidates for surgical treatment and for those who elect not to have surgery for other reasons.


What actually occurs during an EECP treatment is that a person lies on a table and wears special set of cuffs on both legs and the buttocks. The heart is monitored and at varying points in the treatment the cuffs are inflated with air or deflated. This could be considered slightly similar in sensation to having blood pressure taken, except the sensation extends across most of the lower half of the body. Treatments usually take one to two hours, but most people must have 35 of them, which takes about two months.

As inflation/deflation occurs in enhanced external counterpulsation, the heart gets far greater blood flow. This factor is thought to contribute to creating new blood vessels, which in turn may solve some problems associated with angina. Patients who have participated in EECP treatments have favorably reviewed them. Some report greater energy, but more significantly, most report significant reduction in episodes of angina. Results haven’t been shown to be permanent, and many people might need to redo the treatments within a few years.

Not everyone is eligible to participate in EECP. While doctors may have different criteria, people in severe heart failure and those who suffer from arrhythmias are usually not good candidates for enhanced external counterpulsation. Some may be barred from this treatment for financial reasons. Many insurance companies do not pay for EECP, though it appears that this trend could be changing.

Anyone interested in enhanced external counterpulsation might start by discussing it with a cardiologist. The cardiologist may be the best source for finding out if a center or hospital nearby offers it. There are a growing number of independent EECP facilities that are not associated with any particular hospital, but there are also a number of large hospitals that have an EECP department.



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