Chronic stable angina enhanced external counter pulsation

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Chronic stable angina Microchapters

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Editors-In-Chief: C. Michael Gibson, M.S., M.D. [1] Phone:617-632-7753; Cafer Zorkun, M.D., Ph.D. [2]; Associate Editors-In-Chief: John Fani Srour, M.D.; Jinhui Wu, MD

Enhanced External Counter Pulsation (EECP)

Enhanced external counter pulsation (EECP) is another alternative therapy for refractory angina. Most data are from observational studies, which have reported improvement in exercise tolerance and reduction in anginal frequency as well as nitroglycerin use among patients treated with EECP.

EECP has been postulated to decrease myocardial oxygen demand, enhance myocardial collateral flow via increased transmyocardial pressure, and improve endothelial function. The therapy is usually administered over 7 weeks consisting of 35 one hour treatments. Possible placebo effect associated with EECP has not been addressed in many studies, which have not included sham controls.

EECP uses three paired pneumatic cuffs that are applied to the lower extremities. The cuffs are sequentially inflated then deflated.

  • Increases endothelial function
  • Promotes coronary collateral formation
  • Decreases peripheral vascular resistance
  • Increases ventricular function
  • Placebo effect

ACC / AHA Guidelines- Alternative Therapies for Chronic Stable Angina in Patients Refractory to Medical Therapy Who Are Not Candidates for Percutaneous Intervention or Revascularization (DO NOT EDIT)[1][2]

Class IIb

1. Enhanced external counterpulsation (EECP). (Level of Evidence: B)

See Also

Sources

  • The ACC/AHA/ACP–ASIM Guidelines for the Management of Patients With Chronic Stable Angina [1]
  • TheACC/AHA 2002 Guideline Update for the Management of Patients With Chronic Stable Angina [2]
  • The 2007 Chronic Angina Focused Update of the ACC/AHA 2002 Guidelines for the Management of Patients With Chronic Stable Angina [3]

References


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