External Counterpulsation

External Counterpulsation (ECP)

www.externalcounterpulsation.com Click here to see video of ECP (VascuFlo)

Interested in donating to further research on ECP visit www.ECPRF.org

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Definition of ECP
External Counterpulsation is a noninvasive, outpatient procedure to relieve or eliminate angina by improving perfusion in areas of the heart deprived of adequate blood supply. Recent studies indicate that ECP can cause the recruitment of collateral arteries to areas of the heart deprived of a normal blood supply.

Why ECP Works
Significant obstruction in one or more coronary arteries can create a pressure difference between areas of the heart muscle that receive and those that do not receive enough blood. Repeated and pulsed increases in pressure during diastole may stimulate opening or formation of collateral channels access this pressure gradient within the heart muscle, resulting in increased blood supply to deprived tissues. The development of a collateral circulation is particularly important in the heart muscle where it may be life saving.

However, the development of collateral circulation is a gradual process, and not everyone has the same ability to develop these networks. ECP treatment appears to stimulate the natural process of developing collateral circulation, but there are probably other, yet unexplained, mechanisms that contribute to the long lasting effects of ECP treatment.

Treatment Protocol
Treatment with ECP involves a series of 35 one-hour sessions over a period of seven weeks.

Treatments are usually scheduled 5 days a week.

Double sessions are approved in some cases which may ease patient compliance with ECP treatment.

Mechanism of Action
Treatment uses unique equipment to inflate and deflate a series of pneumatic compressive cuffs around the lower extremities.

Treatment in administered on a padded table where three sets of electronically controlled inflation and deflation valves are located.

These valves are connected to specially designed adjustable cuffs that are wrapped firmly, but comfortable around the patient’s calves, lower thighs, and upper thighs, including the buttocks.

The design of the cuffs permits significant pressure to be applied to the arteries and veins at relatively low air pressures.

Timing for inflation and deflation is regulated by running electrocardiogram signals through a microprocessor that monitors the treatment process.


While the heart is at rest the cuffs are inflated in rapid sequence from the calves upward, creating a pressure wave that increases diastolic pressure, coronary artery perfusion pressure, and blood flow to the heart muscle. (shown in steps 1 through 3).

This compression of the blood vessels in the legs also increases the volume of blood returned to the right side of the heart via the venous system.

Instantaneous deflation of all cuffs at the onset of the heart’s contraction lowers the resistance of the heart must pump against, decreasing the heart’s work load.
(shown in step 4).

This latter effect , when coupled with increased venous return, significantly raises cardiac output.

Wikipedia Definition

External Counterpulsation Clinical Summary (.pdf)

External Counterpulsation Case Study (.pps)

See several abstracts in Life Extension Magazine

EECP Offers a Second Chance at Life

EECP Offers a Second Chance at Life, Part 2

EECP Bibliography

External Counterpulsation is also being studied for several other disease states including; Parkinsons; stroke, Dementia; Renal Insufficiency; Diabetic Neuropathy; Restless leg syndrome; Erectyle Dysfunction; and high blood pressure.

Medicare and Insurance Coverage Policies:

United Healthcare Medica Aetna BCBS of North Carolina HIP Wellmark BCBS Medical Card Sys.

Priority Health Care First BCBS Cigna

Cost Comparison/Health Care Savings

Decreased ER visits

Prestigious Centers that offer ECP:

The Cleveland Clinic The Georgia Heart Center The University Medical Center at Princeton Cardiovascular Associates Mayo Clinic Heart Center of the Rockies Central Minnesota Heart Center Lourdes Health System UCSF Cardiology New Mexico Heart Institute Central Babtist Hospital Legacy Heart Care Duke Heart Center Brooksville Cardiology The Braverman Centers Lowell General Hospital Neomed Hospital Prather Wellness Center Katz Cardiomedical Centers Boston Medical Center Cape Fear Valley Stony Brook Univ. Waters Integrative Healthcare

FRIDAY, Sept. 18 (HealthDay News) — Many people with chronic angina experience frequent chest pain that affects their quality of life, a new study finds.

Angina, a tightness or discomfort in the chest caused by narrowing of a coronary artery, can lead to heart attacks.

Australian researchers surveyed more than 2,000 chronic angina patients and found that 29 percent of them experienced chest pain at least once a week, despite receiving treatments such as medications, balloon/stent procedures and bypass surgery.

“More than 60 percent of patients with chronic angina reported that their angina limited their enjoyment of life,” study author John Beltrame, an associate professor at the University of Adelaide, said in a school news release.

“Although quality assurance programs of chronic angina patients examine how well weight, cholesterol and blood pressure are controlled, the one symptom that patients complain about — chest pain — has no defined benchmark,” he said.

The results suggest that a new management strategy is needed to enhance angina treatment, to improve patients’ quality of life. The study was published Sept. 14 in the Archives of Internal Medicine.

“We know that with aggressive lifestyle modification and appropriate medical management, nearly 60 percent of patients with angina can be pain-free after one year,” Professor Nigel Stocks, head of the University of Adelaide’s Discipline of General Practice, said in the news release. “This study highlights the importance of GPs [general practitioners] closely monitoring their patients with chronic angina and encouraging them to report recurring chest pain.”

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