Enhanced external counterpulsation (EECP) is a treatment for 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.
Cuffs, similar to blood pressure cuffs, are placed on the legs. These cuffs inflate and deflate with air to the rhythm of the heart. This helps to push blood back toward the heart, increasing blood flow. Since circulation is improved, the heart does not have to work so hard.
EECP pushes blood back toward the heart to reduce the heart's workload.
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You may have EECP to treat angina if:
The benefits of EECP may include:
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 monitor your heart rhythm. Your blood pressure will also be monitored.
Cuffs will be placed on your calves and upper and lower thighs. The cuffs attach to air hoses that will inflate and deflate them in rhythm with your heart. You will feel strong pressure from the cuffs, beginning at your calves and moving to your upper thighs. The cuffs will inflate 60-80 times each minute during the treatment.
You will be treated for a total of 35 hours. Treatments are usually given each day 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. Updated May 2015. Accessed June 9, 2016.
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 9, 2016.
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 9, 2016.
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 2016 by Michael J. Fucci, DO, FACC Last Updated: 5/11/2013