External CounterPulsation (ECP) therapy is a safe and effective treatment that provides 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 with 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 micro vascular angina (Cardiac Syndrome X)
Heart failure patients in a euvolemic state with:
Ischemic or idiopathic cardiomyopathy
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 location of 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.
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External Counter Pulsation (ECP) significantly increases diastolic and mean pressures and reduces systolic pressure in the central aorta and coronary artery. Coronary artery flow is increased during Increased External Counter Pulsation (IECP). The combined effects of systolic unloading and increased coronary perfusion pressure provide evidence that Increased External Counter Pulsation (IECP) may serve as a potential mechanical assist device and create new pathways for the blood flow to the heart thus better oxygen distribution. This pumps in new life into a patient giving him better movement and exercise potential.