Stable Angina is managed primarily through lifestyle advice, medication therapy, and coronary revascularization procedures. Some patients with refractory angina exhibit symptoms that are not optimally controlled with the optimal medication and revascularization options available. Enhanced external counter-pulsation (EECP) is a technique that can be used to improve symptoms in chronic stable angina.
However, the role of EECP has also been investigated following positive outcomes in patients with both angina and heart failure in multi-center studies.
EECP is accepted by the United States Food and Drug Administration (FDA) for the treatment of refractory angina (Class IIb). About 200 hospitals all over India have equipped themselves with this technology.
USES:
EECP uses three groups of pneumatic cuffs that orderly contract during diastole, enhancing aortic diastolic pressure, improving coronary blood movement, etc.
Improves anginal symptoms and exercise tolerance, and reduces nitro-glycerine use in patients with chronic, stable angina. EECP is also found to be safe and helpful in patients with symptomatic steady congestive heart failure. It has been predicted that the cardiac benefits of EECP are transferred through vascular endothelial growth factor, and nitric oxide creates vasodilatation and angiogenesis. In June 2002, the FDA also validated EECP therapy for heart-stuck patients. EECP is cost-effective if the detected quality of life benefit is deduced to continue all over the patient’s lifetime.
However, there remain uncertainties around the long-term effects of the intervention.
