External Counterpulsation

ECP therapy is a recently introduced non-invasive outpatient treatment for coronary artery disease patients with angina pectoris refractory to standard medical therapy or surgical intervention. Following successful trials, Medicare has recently granted coverage for this treatment option.

In simplest terms, ECP involves sequential inflation and deflation of compressive cuffs wrapped around the patient's legs. These events are timed to the cardiac cycle and provide both an increase in the blood flow to the coronary arteries (inflation when heart is relaxed) and a reduction in the workload to the heart (deflation at the beginning of the ventricular contraction).

In addition to improving the performance of the heart, it is possible that ECP may promote the development of collateral blood vessels ("natural bypasses"). The MUST-ECP trial reported that 1-hour sessions once or twice daily for a total of 35 hrs (course of therapy 7 weeks, if used 1 hour/day Mon-Fri), decrease the frequency of angina and nitroglycerin usage.

Our center is presently testing such treatment options in our patients. Some patients do not qualify for ECP such as those with valvular heart disease, recent heart attack or bypass surgery, deep vein thrombosis, severe Peripheral Vascular Disease, bleeding problems, certain cardiac arrhythmias and pregnant women, among others.