New Non-Invasive Therapy for Chronic Angina
A new non-invasive treatment for chronic refractory angina not amenable to any further revascularization, either percutaneously or surgically is now available in Wilmington, Delaware. The treatment is called Enhanced
External Counter Pulsation (EECP). EECP uses sequential compression of the lower extremities of the body to stimulate the formation of new blood vessels in the heart. It is currently indicated for refractory angina and it is anticipated that it will be indicated for congestive heart failure in the near future.

EECP therapy has proven to be useful in the treatment of chronic (stable) angina. Patients who undergo EECP report fewer anginal attacks and the ability to resume physical activity. Published studies have demonstrated relief from angina pain and improvement in the oxygen-deprived areas of the heart in approximately 78% of patients with stable chronic angina. Most patients report a marked improvement in their functional capacity, energy level and overall quality of life.

The treatment uses fabric cuffs containing inflatable plastic bladders fastened with Velcro around the patient’s calves, thighs and buttocks. The patient lies comfortably on a cushioned table while the cuffs are fastened onto his lower extremities. The cuffs are sequentially air-inflated (first the calves, then the thighs and the buttocks) during diastole, when the heart is momentarily at rest between beats. This does not interfere with cardiac function at all. Compression of the cuffs during diastole forces blood from the legs and buttocks up to the heart, increasing the flow of blood through the coronary arteries, which are severely blocked and helps expand the arteries to increase blood flow to the heart muscle.

EECP therapy does not require any type of anesthesia and generally feels like a vigorous massage. The treatment consists of a one-hour session per day, five days a week, for a total of seven weeks. Although the mechanisms of action are not clearly defined, the prevailing theory is that forcing blood flow at high pressure during diastole in to the coronary arteries increases the formation of new blood vessels (angiogenesis), recruits new collateral vessels and may stimulate growth factors that improve relaxation of the blood vessels. All these mechanisms collectively result in new blood vessel growth around the blockages in the patient’s arteries. In effect, this creates a “natural bypass”. If you have chronic angina and have maximized your medical therapy and are not a candidate for further revascularization, EECP therapy may be an appropriate treatment for you. You may ask your cardiologist for evaluation to determine if you are an EECP candidate.

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