Patient Guide
to EECP® Therapy (PDF)

Physician Guide
to EECP® Therapy (PDF)

 

The EECP® Centre

 

The Ottawa CardiovascularCentre is pleased to announce the opening of Ottawa's first EECP® Centre

 

EECP® therapy is a non-invasive outpatient treatment for congestive heart failure and stable angina. EECP® uses synchronized enhanced external counterpulsation to augment diastolic blood pressure. EECP® has been shown to reduce angina and to improve objective measures of myocardial ischemia in patients with refractory angina 1. Improvement in angina class may be sustained up to 36 months 2. Beneficial effects include:

 

Increased coronary diastolic pressure and blood flow
Reduces myocardial oxygen demand

Increased venous return
Increased cardiac output
Augmented afterload reduction
Prolonged time to exercise induced ST depression
Improvement or resolution of myocardial perfusion defects

 

EECP® has been shown to be safe and well tolerated in patients with refractory CHF. Significant improvements were seen in exercise capacity (peak oxygen uptake and exercise duration), and in quality of life assessments, at 1 week and 6 months after the course of enhanced external counterpulsation. 3

 

Potential mechanisms of benefit include:

 

Improvement in endothelial function
Promotion of coronary collateralization

Enhancement of ventricular function
Peripheral effects similar to those observed with regular physical exercise
Non-specific placebo effects


Indications:

  1. Medically refractory patients with class III-IV angina who are not suitable for PCI or CABG due to:

    a. Small vessel disease

    b. Diffuse CAD

    c. Failed prior revascularization

    d. High risk for revascularization

    e. Significant co-morbidities which  preclude revascularization

  2. Patient with refractory CHF

Contraindications:

  1. Known AAA requiring surgery

  2. Arrhythmias that interfere with machine triggering

  3. Bleeding diathesis

  4. Active thromboplebitis

  5. Severe lower extremity vaso-occlusive disease

  6. Pregnancy

Treatment regimen: A course of 35 hours is the usual treatment regimen delivered over one to two hours daily, at least 5 days per week for 5-7 weeks.

 

Cost: EECP® is not covered by OHIP. Introductory pricing is available for the initial 6 patients. Subsequent costs will be $7000 for a full 7 week therapeutic session. For further information please contact Dr. Joel Niznick, Dr. Brendan Quinn or Lorraine Kluke, Nurse Manager at the Ottawa Cardiovascular Centre.

 

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1 Enhanced External Counterpulsation for Ischemic Heart Disease What’s Behind the Curtain? J Am Coll Cardiol 2003;41:1918 –25.

2 International EECP Registry. Data on File:Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh

3 Enhanced External Counterpulsation in Patients With Heart Failure: A Multicenter Feasibility Study. CHF. 2002;8:204–208, 227.