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What is External Counter Pulsation (ECP)?

This FAQ is provided to help you understand how External CounterPulsation (ECP) may help patients with angina. You should consult with one of our physicians to determine if you would benefit from ECP treatments.

Just what is angina?

Angina is a signal from your body telling you that your heart muscle is not receiving enough oxygenated blood. Over 6 million people in the United States suffer from this condition.

The heart requires an especially enriched supply of oxygen via the incoming blood flow in the coronary arteries. When the vessels that supply the heart with oxygenated blood become narrowed, the area of the heart that is not receiving the proper blood flow responds with a very painful signal called angina pectoris.

What is ECP treatment?

External CounterPulsation (ECP) is a non-invasive procedure that may reduce the symptoms of chronic angina by stimulating the formation of small branches of blood vessels (collaterals), which circumvent the blocked arteries.

Counterpulsation occurs while the heart is resting (diastole). It is during diastole that our CardiAssist system actually pumps, sending blood back to the heart. Air is pumped into a series of cuffs placed on your calves, thighs and buttocks. The cuffs compress your lower extremities in sequence (like a wave) which increases blood flow back toward your heart. The inflation of these cuffs is timed to your heartbeat so the blood arrives at precisely the time the heart relaxes. A fraction of a second before your heart beats again, the cuffs are instantaneously deflated, enabling the blood in your heart to be pumped (systole), with minimal resistance, into your now empty blood vessels. This decreases the amount of work your heart must perform.

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How can ECP help relieve angina?

Your heart is the pump that supplies blood flow throughout the body. It supplies tissues with the oxygen and nutrients that are needed to sustain life. In order to efficiently accomplish this important task, the heart muscle needs oxygen-enriched blood to generate energy for pumping blood to the body. The heart relies on its own set of blood vessels called coronary arteries to receive oxygenated blood.

ECP seems to improve circulation to your heart muscle by opening new pathways that circumvent the blocked arteries.

Many patients see:

  • less medication is required
  • fewer angina attacks
  • they can do much more physically such as walking, golfing and gardening
  • life becomes more "normal"

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How do I know if I qualify for ECP?

Call our office about your specific situation. One of our doctors can evaluate your condition and determine if you are a candidate for ECP. General criteria includes:

  • You have angina symptoms
  • You have had previous invasive procedures, but the pain remains or has returned
  • Nitroglycerin no longer gives you relief
  • Your physician has determined that you are no longer a candidate for any invasive procedure

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Do I need to know anything before having ECP therapy?

Once you know you qualify for ECP therapy there are a few helpful pre-treatment do's, don'ts and facts.

First, you must understand that you are committing to one hour sessions, five days per week, for seven weeks. Interruptions in the daily routine are not good and should be avoided if at all possible. You should plan to spend about an hour and a half each day in our office.

You may feel somewhat tired at the end of the first week, due to the "passive exercise" effect to ECP.

Each day, your therapist will conduct a pre-treatment questionnaire, weigh you and take your blood pressure prior to starting your therapy.

We recommend the following:

  • Arrive at least 15 minutes before your scheduled time
  • Wear the provided stretch tights to reduce skin irritation
  • Wear form fitting underwear, not boxer shorts
  • Wear short socks if possible
  • Consume very little food or fluids before treatment
  • Be sure to urinate before starting the therapy
  • Take your medications as directed by your physician
  • Wear an open necked top, the looser fitting the better
  • Bring music (Tape, CD or MP3 player) or Books on Tape/CD
  • Bring your spouse/friend if you like

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How will I feel during and after I finish the therapy?

Most patients describe the treatment as a vigorous massage. They also say that after you get used to it, reading or sleeping during the treatment is very easy. Right after finishing a treatment many are energized or invigorated, but some feel a little tired.

How long before I feel better?

Every patient is different, but most patients start to see improvement about half way through the seven week cycle. Some feel a positive difference after just a week and some require more than seven weeks.

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Are there any negatives to the therapy?

While most patients only require 35 sessions, some can require more. Also, the seven week commitment can be a serious consideration for some patients. It is very important that sessions are not missed.

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What are my other treatment options?

Some patients may still have the option of bypass surgery, angioplasty, drug therapy or TMR (TransMyocardial Revascularization). You should ask one of our physicians which of the options best matches your situation.

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Does ECP carry any risks?

Though rare, some patients develop minor skin abrasions from the rubbing of the cuff system. The ECP therapist or your physician can describe any potential risk and or complications that may occur.

What advantage does ECP have over other treatments?

ECP is less expensive, non-invasive and doesn't require recuperation after treatment. Rather than checking into a hospital, you visit our office and can drive yourself home after each session is completed.

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