The acronym ECP stands for External Counterpulsation.
ECP is a non-invasive, outpatient treatment for heart disease that is used to relieve or eliminate angina. During the treatment, blood pressure cuffs are wrapped around your legs, and squeeze and release in sync with your heartbeat, promoting blood flow throughout your body and particularly to your heart. In the process, ECP develops new pathways around blocked arteries in the heart by expanding networks of tiny blood vessels (”collaterals”) that help increase and normalize blood flow to the heart muscle. For this reason, it is often called the natural bypass.
- How can I find out if I’m a candidate for ECP Therapy?
You have angina not adequately relieved by medications. You have recurrent evidence of fluid retension and dyspnoea (breathlessness) due to weak heart functions. You have already undergone invasive procedures, but chest pain remains or has comeback. Your cardiologist has determined that you are no longer a candidate for any invasive procedure.
Anyway, you may find this ECP questionnaire helpful to determine the needs of ECP treatment.
Angina is a signal from your body telling you that your heart muscle is not receiving enough oxygenated blood. 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. Angina may feel like chest pain or pressure, shortness of breath, pain in the jaw, neck, arms, back, nausea or generalized fatigue. Each patient experiences angina differently.
- What are the advantages of ECP Therapy?
ECP Therapy is not invasive, does not require a hospital stay, has no recovery period, and allows you to return to your routine each day after receiving treatment.
- What are the benefits of ECP Therapy?
Unlike bypass surgery, balloon angioplasty, and stenting procedures, ECP is non-invasive, carries no risk, is comfortable and is administered in outpatient sessions. Benefits of ECP, including less angina, less nitroglycerin usage, and improved blood flow patterns documented on stress tests, had lasted. Most patients experience positive results, such as the following:
– Having no angina or angina that is less frequent and less intense
– Less or no nitroglycerin use
– Having more energy
– Being able to take part in more activities of daily living with little or no angina or heart failure symptoms
– Enjoying a better quality of life
– Having a more positive outlook
- Is ECP Therapy comfortable?
There is a feeling of pressure from the cuffs around your legs and buttocks. Once you become accustomed to this pressure, the sessions usually pass comfortably.
- How will I feel after the treatment?
ECP therapy is often described as being like “passive exercise,” so you may feel tired after the first few days of treatment. This is normal, especially if you haven’t been exercising. Usually, once this short “training period” is over, you will begin to notice that you have more energy.
The standard course of treatment is one hour per day, five days per week, for seven weeks (a total of 35 one-hour sessions). Some patients have two treatments in one day in order to complete the program more quickly. Some patients extend the program beyond 35 treatments, depending on their particular medical situation and goals.
- When can I expect to start feeling better from ECP?
Each patient responds differently. Most patients begin to experience beneficial results from ECP about halfway through the seven weeks. These benefits include increased stamina, improved sleeping patterns, decreased angina, and less reliance on nitroglycerin and other medications. There is variation, certainly, and some patients start to feel better as soon as in their first week of treatment!
- Can I have therapy more than once?
Yes. If your symptoms return, your doctor will decide if you need to repeat your ECP treatments. ECP is not a once-in-a-lifetime treatment. Heart disease is a chronic illness and symptoms may return at some point in the future.
- What happens if I miss a treatment?
You are encouraged to come for your ECP treatment every day. However, missing a day will not have a negative effect on your overall results. When you come back, you will simply pick up where you left off, and the missed treatment will be added to the end of your program until you have a total of 35 sessions. Just like exercise, the more consistent you are with your ECP schedule, the better your results will be.
- Can I exercise during the weeks I’m receiving ECP Therapy?
Your doctor will discuss an exercise program, how and when you should begin, and how much you should do. Exercising can help you keep the benefits of your ECP treatments.
- Can everyone have ECP Therapy?
Your doctor knows your medical history and condition and will determine if you can have ECP therapy.
- What are the risks of ECP Therapy?
Occasionally, patients develop mild skin irritation in the areas under the treatment cuffs or experience muscle or joint discomfort. Some patients feel tired after the first few treatments but this usually ends after the first week. Rarely, patients develop shortness of breath requiring hospitalization and treatment. Your ECP therapist is trained to make your treatments safe and to minimize risk.
- Does ECP aggravate high blood pressure (hypertension)?
No. If you have hypertension that is properly managed, you may undergo ECP without difficulty. Oftentimes, patients with hypertension find that their blood pressure improves as they proceed with ECP. If your hypertension is uncontrolled, you must seek medical care to get your blood pressure under control with proper medications before proceeding with ECP.
- I have varicose veins. May I still have ECP?
Yes. Varicose veins are typically a cosmetic issue, not a medical one. As such, they do not preclude individuals from receiving ECP. We often use extra padding in patients with varicose veins to ensure maximum comfort.
- I have atrial fibrillation and an irregular heartbeat. May I still have ECP?
Yes. An irregular heartbeat, including one caused by atrial fibrillation, will not interfere with ECP if the heart rate is controlled and no faster than 100 beats per minute.
Yes, and you should! ECP improves blood flow throughout the entire body, including your legs. If you have poor leg circulation, you might need more than 35 treatments. Patients typically require additional treatments to get the full benefit of the program. In addition to improved stamina, less angina, and less nitroglycerin use, patients with PVD have a marked improvement in their leg circulation in response to ECP.
