Information for your perusal...


Facts on ECP (External Counterpulsation) and ESMR or CSWT (Cardiac Shock Wave Therapy)


External Counter Pulsation (IECP)

Cardiac Shock Wave (ESWT)

Indications of Use

  • Stable Angina
  • Unstable Angina
  • CAD, Single vessel, double vessel or triple vessel.
  • Heart Failure
  • Congestive Heart failure
  • LV Dysfunction
  • Cardiomyopathy
  • Cardiogenic Shock
  • Micro-vascular angina

It is only used for treatment of refractory angina. (angina resistant to conventional therapies for coronary artery disease)

Clinical trials

External Counter Pulsation has been tested for decades there are endless number of controlled clinical trials done. It is widely accepted and is being used at more than a 900 centre’s around the world.

Cardiac Shock Wave Therapy or CSWT or ESMR has very few clinical trials and is not used in more than 55 centre’s across the world


Due to its wide range of indications of use the ECP can be administered to a large amount of the cardiac patients making it a better and profitable choice.

ESMR or CSWT is indicated for use on patients suffering from refractory angina. Out of the total cardiac patients only about 6 to 7% of the patients suffer from refractory angina. Out of these 7% not even 1 % opts for CSWT, making it a modality of lesser choice.


In addition to bypassing blockages, creating new blood vessels and strengthening the heart, ECP prompts the release of VEGF, nitric oxide and also stimulates the bone marrow to produce stem cell endothelial progenitor cells, which stimulate the growth of new blood vessel cells that line the arteries.

External Counter Pulsation has a relaxing anti-stress effect and has been shown to decrease anxiety and depression in patients with heart disease. The patient get’s the benefits of one hour of exercise while simply lying on a comfortable therapy bed. There is no other medical treatment that comes close to doing all this.  ECP stands alone in its unique ability to effectively treat all of these issues safely and effectively.

Apart from Cardiac Indications Apart from the cardiological benefits External Counter Pulsation has been found to be helpful in following indications as well:

  • Renal Failure
  • Diabetes Mellitus
  • Erectile Dysfunction
  • Hypertension (High Blood Pressure)
  • Sudden Deafness And Tinnitus
  • Stroke (Brain Attack)
  • Peripheral Artery Disease

 Cardiac Shock Wave therapy administered to myocardium increases capillary density and regional myocardial blood flow. It creates local vasodilation at the targeted areas. The blood flow at the targeted area is improved which is treated with shock waves.

Duration of Therapy

5 weeks, one hour everyday session

9 weeks, 1 session per week

Patient views of therapy

External Counter Pulsation is highly accepted by patients, because of its comfortable therapy. Patients suffering from angina can get this treatment done at early stages and avoid heart attack.
The simplicity of the treatment, just compression of legs like a massage is more acceptable.

Patients refrain from this therapy as Cardiac Shock Wave therapy will pass shock waves to heart. Some patients are a bit uncomfortable with the fact that they will be lying on the table with shockwaves being targeted to heart.