External CounterPulsation – Indications
External CounterPulsation (ECP) therapy is a safe and effective treatment that provides a sustained duration of benefit in patients with disabling angina and angina equivalents, left ventricular dysfunction (LVD), and heart failure. IECP therapy is indicated for use in stable and unstable angina pectoris, congestive heart failure, acute myocardial infarction, and cardiogenic shock.
Patients who can be benefited from External CounterPulsation (ECP)
Patients with angina or angina equivalents who:
- No longer respond to medical therapy
- Restrict their activities to avoid angina symptoms
- Are unwilling to undergo any additional invasive revascularisation procedures
- Have LVD (EF<35%).
- Have co-morbid conditions that increase the risk of revascularisation procedures (eg., diabetes, Heart failure, pulmonary disease and renal dysfunction)
- Have coronary anatomy unsuitable for surgical or catheter-based revascularisation
- Are considered inoperable or at high risk of operative/interventional complications
- Suffer with microvascular angina (Cardiac Syndrome X)
Heart failure patients in a euvolemic state with
- Ischemic or idiopathic cardiomyopathy
- LVD (EF<35%)
- Co-morbid conditions that increase the risk of complications of revascularisation procedures
External CounterPulsation (ECP) however may sadly not be suitably administered to every patient as there are contraindications please click here to know more.
A Non-interventional Natural Bypass technique
Numerous studies have shown that ECP Therapy improves blood flow to the heart muscle in spite of blocked arteries. When ECP Therapy increases blood flow to the heart it opens and expands new networks of small blood vessels within the heart called collaterals. These channels can create multiple natural bypasses around clogged arteries, boosting blood supply to oxygen-deprived areas of the heart thus pumping in more life to the heart.
Blood flow to the heart muscles is not proportionate to the degree of narrowing in a coronary artery. Angiography is done to see the narrowing in only large coronary vessels which is suitable to identify the location of the stenosis, this is essential for angioplasty and bypass surgery. However, angiography cannot visualise small arteries like arterioles and capillaries and cannot assess overall blood flow in a particular area of the heart. For this purpose stress thallium is required.
Improvement with ECP Therapy can be seen through stress thallium tests before and after the procedure.
Before ECP treatment
The position of thallium before being treated by ECP therapy.
After ECP treatment
The position of thallium after being treated by ECP therapy.
