Is Heart disease cramping your lifestyle ?

The patients Information guide to Enhanced External Counterpulsation.

(Non-surgical outpatient safe treatment)

Things you need to know about Enhanced External Counterpulsation (EECP)

Blockage in the coronary arteries which carrying the blood supply to the heart can leads to disabling and severe chest pain, Shortness of breath, poor walking distance and tiredness. Physicians usually treat coronary artery blockage by medicine, angioplasty, stent or Bypass surgery. Despite these therapeutic advances certain problems in the treatment of chest pain persist. Drugs do not always provide relief and invasive procedures have their own associated risks. Many times the blood flow which is restored across the blocked arteries may fail causing re-closing of the arteries.

The search for effective treatment, which can increase the blood flow again by alternative pathway, decreases the chest pain and improve the quality of life without complicated invasive procedures, has yielded the new treatment called Enhanced External Counterpulsation (EECP). This is the only non-invasive, nonpharmaceutical treatment approved by USA FDA.

EECP is a boon for patients who may want to avoid undergoing Invasive treatments.

What is EECP therapy?
EECP therapy is an outpatient treatment for patients suffering from chest pain and poor heart function. During the treatment the patient lie on a comfortable table with large blood pressure –like cuffs wrapped around his / her legs and buttocks. These cuffs inflate and deflate at specific times between patient’s heart beats.

A continuous electrocardiogram (ECG) is used to set the timing so the cuffs inflate while the heart is at rest, when it normally gets its supply of blood and oxygen. The cuffs deflate at the end of that rest period just before the next heart beat. The special sensor applied to your finger checks the oxygen level in your blood and monitors the pressure waves created by the cuff inflations and deflations.

Mrs. Parvathy 57 Yrs old Lady had two Angioplasties in the past 5 years. She is recently admitted in the hospital fot having severe shortness of breath even while doing routine householdwork. Echocardiograhy reveals she has poor heart function. Her left ventricular heart function was only 25%. She underwent EECP for her shortness of breath and fatigue. On completion of 35 sessions she is able to take care of all her household activity and now able to do her shopping and climbing the staircase easily without any shortness of breath. Her repeat Echocardiography shows her Left ventricular heart function is now improved to 40%. She thanks EECP for her new lease of life. What are all the symptoms that show my heart failure is getting worse ? Whenever you are taking your medication and following up with your physician regularly it will prevent your heart failure symptoms getting worse. If you feel any of the following symptoms have started slowly or getting worse day by day it's time to visit your physician.

EECP Therapy uses the patients own blood flow to stimulate new vessels formation around blocked arteries.

How long does the treatment take ?
EECP involves 35 days of treatment. Each treatment session is for 1 hour and the patients are asked to come six days a week for six weeks.

What is collateral circulation?
Formation of network of tiny blood vessels, which make it possible for blood to detour around blocked vessel or narrowed arteries, is called collateral circulation. However the development of collateral circulation is a gradual process and not everyone has the same ability to develop these networks at the rate that will relieve angina. EECP treatment triggers and accelerates this collateral circulation and makes it permanent.

What are the advantages of the EECP Therapy?
EECP Therapy is non-invasive, does not require a hospital stay, has no recovery period and allows you to return to your routine each day work after receiving the treatment.

How do I personally know the treatment has helped me ?

• Patient can walk more distance without chest pain.
• Patient would have fewer or no angina
• Episodes of angina would be less painful
• Patient’s need for anti-anginal medications can be reduced
• Patients can return to work and can participate in their active life style once again
• Patient would be more energetic

EECP is the only Non-Invasive treatment which can improve your collateral blood flow.

Is EECP treatment 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.

What are the risks of EECP Therapy?
Occasionally, patients develop mild skin irritation in areas under the treatment cuffs or experience muscle or joint discomfort. Some patients feel tired after the first few sessions but this usually ends after the first week. Your EECP Therapist is trained to make your treatments safe and to minimize risk.

How long to the benefits of EECP therapy last after a course of treatment?
The International EECP Patient Registry (IEPR) collects data on the safety, effectiveness and long-term benefits of EECP therapy. The current Research data have shown that the benefits of EECP Therapy can last up to three to five years after completing the first course (35 hours) of treatment.

What should I do after the EECP Treatment?
To prevent the progressive of your disease after completion of the treatment you should make life style changes like:

• Quit smoking
• Controlling obesity
• Doing regular exercise
• Following heart friendly diet

Have regular follow-up with your cardiologist to lower your cholesterol, to control your blood pressure and diabetes. EECP treatment provides you new vessels. It is you to prevent your vessels from developing obstructions again.

When can I expect to start feeling better from EECP?
Most of the patients begin feeling the clinical improvement from EECP between 15 to 20 sessions. These benefits includes increase in overall energy level, decrease in angina or shortness of breath, completely stopping or decreasing nitroglycerin medication and increase in walking distance.

What if I miss a treatment session?
Having your EECP therapy each day of the six week treatment course is an important part of receiving the greatest benefit. Missed treatments can be adjusted. You have to complete all the 35 treatment sections.

What are my symptoms which make me eligible for undergoing EECP treatment?
If you say yes to any of the symptoms mentioned below affects your regular lifestyle and activity consider EECP and consult with your physician.

These symptoms may be the signs of your heart getting lesser oxygenated blood than its requirement. Your blood vessel carrying nutrition to your heart muscle may have been obstructed. Your heart pumping action may have been severely reduced making your heart unable to pump enough blood to nourish all other organ in your body. Missing this early signs is like denying yourself a healthy heart and happy living.

EECP Therapy is the safest option for patients who are high risk for bypass surgery, balloon angioplasty or stent.

Is there any difference between well established EECP and ECP/SECP?
Yes. EECP and ECP are very different treatment. EECP is manufactured by Vasomedical USA a world leader in non-invasive treatment t h r o u g h E E C P a n d ma n a g i n g cardiovascular system. Vasomedical has a patent on the timing mechanism of the system (Microsecond precise timing when the cuff inflates and deflates). This timing mechanism and training to the operators to analyze the timing mechanism distinguishes EECP system from other less established ECP/SECP systems. In EECP there are more than 100 published studies in major cardiology journal to prove this timing mechanism on patient treatment effectiveness and safety. Accordingly, EECP –not ECP/SECP machines are the ones found in major cardiology center and university across India, USA and Europe.

Mr. Mahesh 48 yrs old man with diabetes for the past 10 yrs started experiencing moderate t o s e v e r e c h e s t discomfort with profuse sweating while working on his book shop. His treadmill test is positive for coronar y ar ter y disease and a follow up Angiogram shows severe diffuse triple vessel disease. Due to his diffuse nature of the blockage in smaller vessels he is asked to continue his medication b u t s t i l l h i s p a i n persisted. He came to know about EECP and underwent 35 EECP sessions. Now he is completely free from chest discomfort and he is able to work longer hours in his book shop.

As a patient you have the right to know which system is used for your treatment and whether it is FDA approved. The center should also show the FDA approval certificate if you request for it.

Are you a candidates for EECP Therapy?
You may be a candidate if:

• You have Angina (Chest pain) and / or heart failure.
• Your heart medications no longer relieve your angina and heart failure symptoms.
• You have had open-heart (by pass) surgery, a balloon angioplasty or stent, or other invasive procedures, and your symptoms have returned.
• You have been told you cannot have another bypass surgery, balloon angioplasty or stent, or other invasive procedures.
• You have chosen not to have any further surgery, angioplasties or invasive procedures.
• You do not have any other medical conditions that may prevent you from having EECP Therapy.