The Advanced Cardiac Care Center at Granite Medical

EECP© and Traditional Angina Treatment

Depending on the severity of the problem, there are three traditional approaches to managing this chest pain and they depend on the severity of the blockage.

For less severe blockages, drugs can alleviate the pain. Drugs work by relaxing or widening the arteries to increase the flow or by slowing down the pulse and reducing the demand.
In more advanced cases, a tube called a catheter is inserted into the arteries where it will open the blockage in a procedure called angioplasty.
In the most advanced cases, a coronary artery bypass is performed. In this procedure, the blockage is bypassed by surgically creating a new pathway for the blood. While it is quite common, coronary artery bypass is major surgery.

Listen to
Dr. Alan Berrick
talk about EECP
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Dr. Alan Berrick
Medical Director
Advanced Cardiac Care Center

EECP: A new, non-surgical treatment

EECP provides a fourth option. It is non-surgical, painless, involves no drugs, is proven to be clinically effective, and is FDA-approved.

Unlike surgical procedures that seek to internally modify the circulatory system by removing or bypassing obstructions, EECP seeks to externally influence changes and it does so by using a technique called, "counterpulsation." When the heart is at rest, the EECP system increases the blood flow to the coronary arteries.

Why EECP reduces the pain of angina

To understand why EECP is effective, it is important to see how the heart works. The heart supplies nourishing blood to all of the muscles and organs of the body. Ironically, all of this blood passing through the heart does not nourish the heart itself. Instead, the heart depends upon a special set of arteries to provide the blood that it needs. These are the coronary arteries.

When the heart muscles contract, blood is sent to the muscles and organs of the body to nourish them. Contraction is called the systolic phase. When the heart is at rest for the fraction of a second between contractions it is in the diastolic phase. (This is why your blood pressure is given as two numbers: the systolic and diastolic pressure.)

Most of the body's arteries deliver oxygenated blood during the compression or systolic phase. But because the coronary arteries are compressed and narrowed along with the heart muscles during the systolic phase, they deliver blood only when the heart is at rest and the coronary arteries are open.

EECP works to increase the flow of blood through the coronary arteries when the heart is in the relaxed or diastolic phase. EECP compresses the arteries in the lower extremities by inflating the pressure cuffs in sequence from the lowest part of the legs to the highest. When the heart again compresses in the systolic phase, the pressure cuffs deflate immediately, greatly reducing the workload on the heart.

Shown below is an animation that demonstrates how EECP works. If this animation is not visible on your computer, you can download the Flash player for free at the Adobe website.

The process is also shown in a series of illustrations lower on this page

The illustrations below demonstrate how the pressure cuffs work.


Step One The lowest cuffs inflate, beginning the counterpulse.	Step Two The middle cuffs inflate, advancing the counterpulse.	Step Three The upper cuffs inflate, advancing the counterpulse.	Step Four All cuffs immediately deflate, making it easier for the heart to pump.

In EECP, the diastolic (relaxed) pressure is often higher than the systolic (compressed) pressure. Which is the opposite of the usual relationship.

The body responds to this increased pressure and flow by developing a path around the obstruction. Doctors refer to this as collateral circulation. Given time, the human body would naturally develop a path around a blockage. Unfortunately, this is a gradual process that takes too long to help. EECP is believed to speed up the natural healing process to encourage the body to create the bypass over weeks instead of years.

EECP does involve a commitment

EECP treatments are usually administered in a set of 35 sessions over a seven-week period, so a commitment of time is needed. The treatments last about an hour and you can go home or back to work after your session. There may be some slight discomfort as the cuffs inflate, but there is no pain.

The results