EECP

EECP

Enhanced External Counter Pulsation

Non-surgical outpatient treatment: EECP is a non-invasive procedure performed on an outpatient basis. Uses external pressure cuffs: EECP involves applying external pressure cuffs to the lower extremities. Enhances heart blood flow: EECP improves blood flow to the heart through rhythmic cuff inflation and deflation.

Mechanism of Action

EECP exerts its therapeutic effects through several mechanisms:

Increased Diastolic filling

By inflating cuffs during diastole, EECP boosts arterial pressure, enhancing coronary blood flow and ensuring efficient oxygen delivery to the heart muscle.

Reduced Afterload

EECP decreases peripheral resistance, lowering afterload and allowing the heart to work more efficiently.

Improved Coronary Blood Flow

EECP stimulates the growth and dilation of collateral vessels, providing alternative routes for blood flow and reducing ischemic burden on the heart.

Collateral Vessel Growth

EECP triggers the release of nitric oxide promoting the development of new collateral vessels, further improving blood flow to the heart.

Evidence-based Research

Dr. Sama Akber conducted a study to investigate the impact of Enhanced External Counter Pulsation (EECP) on left ventricular (LV) function, measured through strain analysis. The research focused on patients with refractory angina and heart failure symptoms.
Dr. Sama Akber was awarded for his ground breaking research on the effect of EECP in heart failure at the CSI 4th National Heart failure conference.

Note: Dr. Sama Akber's study provides valuable insights into EECP's impact on LV function. For detailed information, refer to the original research article.
• 7% increase in ejection fraction from baseline in patients with heart failure
• Increase in 6 minute walk distance covered by 100 mts Reduction in NYHA* class by 1 stage

The Benefits of EECP

Basic Benefits
• EECP improves blood flow, reducing chest pain.
• EECP enhances cardiovascular function, boosting endurance.
• EECP may reduce reliance on cardiovascular medications.

Advanced Benefits

• Stimulates the growth of natural bypass vessels, improving blood flow to the heart.
• Enhances vascular health and overall cardiovascular function.
• Improves symptoms, exercise capacity, and cardiac function.
• Enhances blood flow to the limbs, reducing symptoms.
• Enhances quality of life, reduces anxiety and depression, increases energy levels.

Indications for EECP

Coronary Artery Disease (CAD)

Refractory Angina: EECP relieves refractory angina and enhances exercise tolerance.

Stable Angina: EECP improves stable angina symptoms and enhances quality of life.

Incomplete Revascularization: EECP enhances blood flow and collateral vessel growth in incomplete revascularization.

Heart Failure

Symptomatic Relief: EECP improves heart failure symptoms, enhancing quality of life.

Enhanced Cardiac Function: EECP improves cardiac function in heart failure patients through enhanced coronary blood flow and collateral vessel formation.

Other Indications

Peripheral Artery Disease (PAD): EECP improves PAD symptoms by enhancing lower limb blood flow and exercise capacity.

Microvascular Dysfunction: EECP improves microvascular dysfunction, enhancing angina symptoms and exercise tolerance.

Implementing EECP in Clinical Practice

Patient Selection:

• Suitable candidates for EECP: Stable angina, refractory angina, and incomplete revascularization patients.
• Diagnostic confirmation of CAD required prior to EECP consideration.
• Assess medical history, symptoms, and cardiovascular health to determine eligibility.

Treatment Protocol:

• Recommended treatment: 35 one-hour sessions, five times per week, over seven weeks.
• Cuff application: Calves, thighs, and buttocks while patient lies comfortably.
• Cuff inflation and deflation enhance blood flow, promoting arterial dilation and increased coronary blood flow.

Integrating EECP with Existing Therapies:

• EECP combined with medication, lifestyle changes, and revascularization. (Angioplasty / Bypass Surgery)
• Beneficial for incomplete revascularization and non-ideal candidates.
• Integration with cardiac rehab to benefit patients in heart failure.

Clinical Outcomes and Safety

Efficacy

• EECP improves angina, exercise tolerance, and quality of life.
• Reduces angina frequency and nitroglycerin usage.
• Enhances exercise capacity and endurance. Improves quality of life in heart failure.

Safety Profile:

• Non-invasive therapy with low risk.
• No surgery or medication required.
• Well-established safety record, minimal side effects.
• Comfortable procedure with no significant discomfort or downtime.
• Suitable for a wide range of patients, including those ineligibles for invasive procedures.

Success Stories

"EECP therapy at Oxymed Hospitals has been a game-changer for me. With their expert supervision, I've witnessed a remarkable improvement in my heart's condition. This non-invasive treatment has brought new life and hope. I'm grateful for the incredible benefits of EECP that have revitalized my journey to wellness."

“Against all odds, Dr. Sama Akber and the team at Oxymed Hospitals have given me hope. With improved oxygen levels and heart rate, they have paved the way for my surgery even though I was told no surgery was possible. I am grateful for their encouragement and expertise.”

Mr K. S .R suffered from a massive heart attack and this led him to have a complicated angioplasty. After the angioplasty he was unstable and had low BP despite medicating .He was still symptomatic having recurrent bouts of fainting and falling down. He was put on EECP with constant monitoring and regular guideline directed medical management.10 months later he remains stable and now he travels 100 km daily and is symptom free..

Mr. H. A. suffered from massive heart attack and underwent angioplasty in his home country of Oman. However because of the late nature of presentation he went into heart failure .He came to India seeking cardiac rehabilitation. After a complete course of EECP along with hyperbaric oxygen therapy ,his blood pressure stabilized and he was able to take all the required medications .A person who could not walk more than 100m with out being breathless is now able to walk at least 4km today. This can be attributed to the cardiac rehabilitative facilities namely EECP and HBOT at Oxymed Hospitals.