E C P Service
Price On RequestExternal Counter Pulsation Service has developed over the past 44 years. It has now become a practical way to increase blood flow to the ischemic myocardium and other organs throughout the body. While it may seem that the theoretical benefits of external counter pulsation are evident, this non-invasive method for treating coronary artery disease had been eclipsed by other technologies until the past few years. The first systems built and tested used water as the compression medium and produced mixed results, however, when augmentation was positive, good results were observed. Only Non Invasive Alternative To Treat Heart Disease Never treatment modalityCompletely safeNo surgeryNo painNo interventionOut patient treatment "A non-invasive therapy for chronic Angina Pectoris" External Counter Pulsation (ECP) is a noninvasive, outpatient treatment for coronary artery disease with angina refractory to medical and/or surgical therapy. A series of three compressive air cuffs which inflate and deflate in synchronization with the patient's cardiac cycle via microprocessor-interpreted ECG signals are wrapped around each leg; one at calf level, another slightly above the knee and the third on the thigh. The cuffs are larger versions of the familiar blood pressure cuff. During diastole the three sets of air cuffs are inflated sequentially (distal to proximal) compressing the vascular beds within the muscles of the calves, lower thighs and upper thighs. This action results in an increase in diastolic pressure, generation of retrograde arterial blood flow and an increase in venous return. The cuffs are deflated simultaneously just prior to systole, which produces a rapid drop in vascular impedance, a decrease in ventricular workload and an increase in cardiac output.In the short-term, this method of therapy is thought to deliver more oxygen to the ischemic myocardium by increasing coronary blood flow during diastole, while at the same time reducing the demand for oxygen by diminishing the work requirements of the heart. Long-term benefit is expected to result as coronary collateral flow to ischemic regions of the myocardium is increased. A full course of ECP typically involves 5 hours of treatment per week, delivered in 1- to 2-hour sessions for 7 weeks, for a total of 35 hours of treatment (Arora, et al., 1999; CMS, 2006). The pivotal randomized controlled trial of ECP, the MUST-ECP trial, employed a 35-hour protocol (Arora, et al., 1999). There is no reliable evidence that clinical outcomes of ECP are improved with prolonged courses of treatment. Michaels, et al. (2005) reviewed registry data to assess the frequency, efficacy, predictors, and long-term success of repeat ECP therapy in relieving angina in patients who had chronic angina and had undergone a full course of ECP. Within 2 years of the initial course of ECP, the rate of repeat ECP was 18%, which occurred at a mean interval of 378 days after initial ECP. Of those who underwent repeat ECP, 70% had a decrease of 1 or more angina classes at the end of repeat ECP with similar decreases in nitroglycerin use. Although patients who underwent repeat ECP did benefit from the 2 courses of therapy, the symptomatic improvement was not sustained. Of the patients who had repeat ECP, 59% also had class 0 to II angina compared with 82% of those who did not undergo repeat ECP (p