American Perfusion Institute

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What Is External Counterpulsation Therapy?

External Counterpulsation therapy (ECP) is a noninvasive, atraumatic procedure that reduces the symptoms of angina, by increasing coronary blood flow in ischemic areas of the heart.
The beneficial effects of ECP on perfusion of the ischemic myocardium in patients with coronary artery disease are sustained between treatments, and may persist long after completion of a course of therapy.

External Counterpulsation involves the use of the ECP Device to inflate and deflate a series of compressive cuffs wrapped around the patient's calves, lower thighs, and upper thighs. Inflation and deflation of the cuffs are modulated by events in the cardiac cycle via computer-interpreted ECG signals.

During diastole, the cuffs inflate sequentially from the calves proximally, resulting in augmented diastolic central aortic pressure and increased coronary perfusion pressure. Compression of the vascular bed of the legs also increases venous return and cardiac output. Rapid and simultaneous decompression of the cuffs at the onset of systole permits systolic unloading and decreased cardiac workload. In the treatment regimen established to date, patients are treated with ECP 1 hour daily for a total of 50 hours. At that start of treatment, external compression is progressively increased, as needed, to raise diastolic pressures gradually. Finger plethysmography is used to monitor correct timings.