Two-Year Clinical Outcomes After Enhanced External Counterpulsation (EECP) Therapy in Patients With Refractory Angina Pectoris and Left Ventricular Dysfunction (Report from the International EECP Patient Registry)

Clinical effects of enhanced external counterpulsation treatment in patients with ischemic heart failure

“…Unlike intraaortic balloon counterpulsation, EECP also increases venous return further, enhancing thus cardiac output (20,21). Furthermore, as diastolic inflation pressure is increased, the preload is increased, afterload is decreased, contractility is increased and mechanical efficiency is neutral (17). It could be easier to understand why EECP therapy resulted in a significant improvement in functional capacity if it would be given attention of its effect on the circulation.…”

“…These compressive cuffs are designed to be wrapped around the patient's lower extremities and buttocks. A cardiologist and the EECP therapist, a specialized technician, sets cuff inflation and deflation to the cardiac cycle guided by the electrocardiogram (ECG); systolic and diastolic pressure augmentation during EECP is monitored using finger plethysmography (17). Cuffs are timed to inflate sequentially from the calf to the lower thigh to the upper thigh and buttock just after the onset of diastole, and then deflate simultaneously prior to the beginning of systole.…”

The Role of Enhanced External Counter Pulsation Therapy in Clinical Practice

“…At least a 50% reduction in frequency of angina was experienced by 76% of patients as well as improvement in quality-of-life assessment that was sustained for at least 2-years. 7,8 Loh et al 11 conducted a follow-up review in 2008 that followed 1061 patients from the IEPR-1 (previously described) who maintained significant improvements in both weekly anginal events and quality of life at 3-years following completion of EECP therapy, compared with data obtained 1-week post-therapy.…”

The role of enhanced external counterpulsation in the treatment of angina and heart failure

“…On the other hand, in IEPR patients with an EF of 35% or less, 81% had no occurrence of congestive heart failure two years post-treatment. The MACE rate was similar between the group that showed improvement in angina class and the group that showed no initial improvement, but the rate of unstable angina was significantly increased in those who did not show initial improvement (24).…”

“…Data from the IEPR reveal that after six months, there was a significant increase in MACEs, death, congestive heart failure and cardiac hospitalization in patients with a history of heart failure, with an EF of 35% or less portending a worse outcome (22). This was markedly evident in patients not able to complete the full course of EECP (23); after two years, there was a significant decrease in survival rate in those patients who did not complete treatment (24). On the other hand, in IEPR patients with an EF of 35% or less, 81% had no occurrence of congestive heart failure two years post-treatment.…”