Alternative available for heart patients
Three Quincy residents to try it out
By SUE SCHEIBLE
The Patriot Ledger
Monday, September 17, 2001
Quincy - Robert Freda, 60, had his first heart attack 17 years ago while fighting a fire in Boston. Two bypass surgeries have not ended his severe chest pain.
"I can't do anything near to where I used to," he said. "I used to walk Wollaston Beach every day and was up to four miles an hour, but now, it takes me an hour to do a mile."
The pain will hit any time.
"I feel a tightness around my neck, throat and chest area, and I have to stop what I am doing and take a nitroglycerin pill," he said.
On Wednesday, Freda will undergo an alternative medical procedure he hopes will restore his active life. And he won't have to go near a scalpel to do it.
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"I want to get back to doing things the way I used to," he said. Freda is among three Quincy residents who will be treated as an outpatient using a system in which large pressurized cuffs are wrapped around the legs and lower body to redirect blood flow. It has been used for years in China and can in some cases replace riskier heart surgery. |
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Granite Medical Group in Quincy will begin doing Enhanced External Counterpulsation on three patients with angina, the crippling chest pain caused by blocked coronary arteries. Cardiologist Alan Berrick said his group was the first medical practice in the Boston area to offer the specific EECP procedure provided by Vasomedical Inc.
Freda was referred to Berrick by his cardiologist, Neil Berman.
There are three traditional treatments for angina, which affects some 7 million Americans: medication such as nitroglycerin, invasive bypass surgery and angioplasty.
EECP is noninvasive. The patient lies on a padded table and pressure cuffs are wrapped around the calves, thighs and buttocks. The cuffs are inflated to force blood up to the heart. The pressurization system pumps between heart beats, when the heart is resting, and over time, the added circulation to the heart can open new pathways around narrowed arteries.
EECP (Enhanced External Counterpulsation)
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"It's a new and very effective treatment that a lot of people don't know about," Berrick said. "Most people can expect it to improve their angina."
The bursts of pressure cause patients to rock on the table, but Berrick said there is no pain. Patients describe a feeling like a blood pressure cuff being inflated every second or a strong hug moving up their legs.
EECP is not a cure for coronary artery disease, but a way to manage it and improve quality of life. The long-term results in this country remain to be seen.
The coronary arteries have many branches and when a main artery is blocked, the body can often increase the amount of blood flowing to the heart muscle by opening up tiny new vessels. These networks provide collateral circulation by creating detours around blockages in the larger arteries.
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The procedure has been used on 5,000 patients worldwide, but has only been approved in the United States since 1995. "I was very skeptical at first, like many doctors still are," Berrick said. "It looks kind of hokey - to see someone hooked up looks kind of strange. But gradually, I became a believer. In the next 12 to 18 months, you'll see it offered in a much more extensive way." EECP has been approved by the federal Food and Drug Administration specifically to treat angina. It is being evaluated for use in treating congestive heart failure and other cardiac problems such as implanting stents in arteries. |
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Berrick said studies indicate EECP brings relief from angina pain in 70 to 80 percent of patients. Two or three years later, 80 percent of those who benefited initially still report improved quality of life. There is no age limit, and a recent study found people 80 and older, who have much higher death rates in traditional bypass surgery, benefited nearly as much as younger people.
The basic external pressurization procedure has been around for 50 years but until recent technological advances, the equipment was very cumbersome.
"It began in China and has been successfully used in countries where there is less of a rush to push people into surgery," Berrick said.
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While it takes 35 treatments over seven weeks to get the full benefit, some patients notice improvements within two to three weeks. Patients who complete the treatment have reported they can walk farther, carry heavier packages, and be more active with fewer or no angina attacks. Granite Medical, in Crown Colony, has a waiting list of 12. "They are all very excited about it," said Barbara Brangiforte of Weymouth, a licensed practical nurse, who is coordinating the treatments. Granite Medical has invested $220,000 in the equipment. Berrick has been getting calls from cardiologists at Boston teaching hospitals who may refer patients. He said his own colleagues, once skeptical, are showing interest. "From a cost-benefit basis, it is much less costly than surgery or angioplasty," Berrick said. "But I'm excited because I expect it will make dramatic improvements in many patients' lives with much less risk" than surgery. Medicare will reimburse approximately $6,000 for the 35 treatments. Bypass surgery costs about $50,000 and angioplasty, $14,000. In its policy statement extending coverage to EECP, Medicare stated that while questions remain, the procedure does appear to benefit some patients who cannot have other treatments. Vasomedical has more than 300 systems on the market at 150 medical centers or practices, including a location in Falmouth. |
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Where to learn more
Dr. Alan Berrick and nurse Barbara Brangiforte may be called at 617-479-2273.
There is a follow up article that was published
in the January 9th Patriot Ledger. To read that article, click here.