Enhanced external counterpulsation (EECP) is a treatment for the heart. It uses inflated cuffs on the legs to help push blood back to the heart. It improves circulation and decreases the workload of the heart.
chronic, stable chest pain known as angina. Angina happens when there is not enough blood and oxygen being pumped to the heart to support the work it is doing. EECP may also be used to treat certain people with heart failure.
EECP is used to treat angina. Angina is chest pain caused by poor blood flow to the heart muscle. EECP can increase the amount of blood going to the heart which can relieve the pain. You may have EECP to treat angina if:
EECP may lead to:
Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems, like:
You should not have EECP if you are pregnant or have any of these conditions:
Before you begin EECP, your doctor may:
You may want to wear tight-fitting, seamless pants. This can help prevent chafing from the cuffs.
You will not be given any anesthesia. EECP is not painful.
You will lie on a padded table. Electrodes will be placed on your chest to watch your heart rhythm. Your blood pressure will also be checked often.
Cuffs will be placed on your calves and thighs. The cuffs attach to air hoses. They will inflate and deflate the cuffs in rhythm with your heart. You will feel strong pressure from the cuffs. The cuffs will inflate 60 to 80 times each minute during the treatment.
You will be treated for a total of 35 hours, spread out over 7 weeks.
EECP is not painful. You may feel uncomfortable when the cuffs tighten on your legs.
After your treatment, the electrodes and cuffs will be removed. You can go home as soon as you are done with treatment. You may feel slightly tired after the treatment. This feeling will get better over time.
When you return home, do the following to help manage your angina:
After arriving home, call your doctor or call for medical help right away if there are signs that your angina is getting worse:
If you think you have an emergency, call for emergency medical services right away.
American Heart Association
National Heart Lung and Blood Institute
Canadian Cardiovascular Society
Heart and Stroke Foundation of Canada
Amin F, Al Hajeri A, Civelek B, et al. Enhanced external counterpulsation for chronic angina pectoris. Cochrane Database of Systematic Reviews. 2010;2:CD007219.
Enhanced external counterpulsation. Cleveland Clinic website. Available at: http://my.clevelandclinic.org/heart/disorders/cad/eecp.aspx. Accessed June 20, 2018.
What is angina? National Heart Lung and Blood Institute website. Available at: http://www.nhlbi.nih.gov/health/health-topics/topics/angina. Updated June 1, 2011. Accessed June 20, 2018.
What is angina? American Heart and Stroke Association website. Available at: http://www.heart.org/idc/groups/heart-public/@wcm/@hcm/documents/downloadable/ucm_300287.pdf. Published 2015. Accessed June 20, 2018.
Manchanda A, Soran O. Enhanced external counterpulsation and future directions: step beyond medical management for patients with angina and heart failure. J Am Coll Cardiol. 2007;50(16):1523-1531.
Last reviewed June 2018 by Michael J. Fucci, DO, FACC Last Updated: 12/28/2018