FAQ

1. What is enhanced extracorporeal counterpulsation therapy (EECP)?

EECP is a safe, non-invasive and clinically proven therapy that uses advanced auxiliary equipment to pump blood from the legs back to the heart and various organs, which can promote blood flow, improve cardiovascular and overall health, and achieve remarkable and long-lasting results.

2. What are the work principles of enhanced extracorporeal counterpulsation (EECP)?

The device system senses the user's heartbeat rhythm through compression cuffs (BP-like cuffs) attached to the calves, thighs, and buttocks and electrodes placed on the chest. It inflates regularly between each heartbeat to compress blood vessels and help blood flow back to the heart.

EECP extracorporeal counterpulsation therapy can not only reduce the heart's workload but also help vasodilation and improve blood circulation; It also promotes the proliferation of new blood vessels and improves arteriosclerosis and blockage.

3. What are the benefits of enhanced extracorporeal counterpulsation (EECP) for the body?

Treatment of various conditions

Enhanced extracorporeal counterpulsation therapy (EECP) has been approved by the US Food and Drug Administration (FDA) for the treatment of angina (chest pain caused by insufficient blood supply to the heart). In addition, many studies have shown that enhanced extracorporeal counterpulsation therapy (EECP) also has an ameliorating effect on:

- Cardiovascular disease
- Cardiovascular and cerebrovascular diseases
- Abnormal blood pressure
- Hardening of the arteries, blockage of blood vessels
- Abnormal glucose metabolism
- Kidney disease
- Male sexual dysfunction

Prevention and Healthcare

Since EECP can promote blood circulation, and help take away carbon dioxide and metabolic waste; It also smoothly delivers oxygen and nutrients to all parts of the body, including organs such as the brain, heart, kidneys, liver, and skin, thus improving overall health.

In particular, many symptoms associated with poor blood circulation are improved, such as fatigue, weakness, shortness of breath, dizziness, numbness, and swelling, among others.

4. Is enhanced extracorporeal counterpulsation (EECP) recognized?

In terms of official certification, EECP was approved by the US Food and Drug Administration (FDA) in 1995 for the treatment of angina, and has since been recognized by the European Society of Cardiology (ESC).

In terms of insurance coverage, EECP treatment has been covered by Medicare and Medicaid Services (CMS) since 1999 for the treatment of angina, and is now covered by some major foreign insurance companies such as Bupa, Cigna and Regent Insurance Group.[1]

In terms of academic research, scholars in many countries have published many papers on the clinical benefits of EECP, such as the United States, Australia, Russia, China, Italy, Sweden and Indonesia.

5. Who is enhanced extracorporeal counterpulsation (EECP) suitable for?
  • Patients with chronic stable angina
  • People with cardiovascular disease, cardiovascular and cerebrovascular diseases, abnormal blood pressure, hardening and blockage of blood vessels, abnormal glucose metabolism, kidney disease or male sexual dysfunction
  • Those with poor blood circulation or insufficient blood gas, such as fatigue, weakness, shortness of breath, dizziness, numbness or swelling
  • Sports and fitness people, such as muscle tension, fatigue, pain, sports strain, etc
  • For everyone concerned about health
6. Who is enhanced extracorporeal counterpulsation (EECP) unsuitable for?

Enhanced extracorporeal counterpulsation (EECP) should not be performed if:

  • Have had surgery within six weeks prior to the course of EECP
  • Have had cardiac catheterization within two weeks prior to the course of EECP
  • Irregular heart rhythm
  • Persons equipped with dual-chamber pacemakers
  • Active vein insufficiency (heart valve problems)
  • Congestive heart failure
  • Severe lung disease
  • Circulation problems involving the legs or pelvis
  • Current or previous blood clots, venous thrombosis, or thromboembolism
  • Severe hypertension (systolic blood pressure ≥ 180 mmHg or diastolic blood pressure ≥110 mmHg)
  • Have a bleeding disorder
  •  Ongoing anticoagulant therapy INR>1.5
  • When performing EECP therapy, heart rate< 35 or> 125 beats / min
  • Infection, open wound, burn, or fracture of the leg or pelvis
  • Have an aneurysm (aortoma, brain tumor, or other)
  • Pregnancy (women should have a pregnancy test before undergoing EECP treatment)
7. For patients with chronic stable angina, what are the advantages of enhanced extracorporeal counterpulsation (EECP) over other treatments?

Enhanced extracorporeal counterpulsation (EECP) is a non-invasive, non-surgical, and non-invasive treatment with little risk. Clinical studies have shown that the efficacy of EECP treatment is comparable to that of conventional treatments such as Tom Po Tsai and bypass surgery. EECP treatment is not only effective, but also lasts for up to 5 years. [2]

8. If I have congestive heart failure (CHF), can I receive enhanced extracorporeal counterpulsation (EECP) ?

Many studies have pointed to a clear benefit of EECP extracorporeal counterpulsation therapy in some patients with congestive heart failure.[3]

9. Can I undergo enhanced extracorporeal counterpulsation (EECP) if I have previously undergone balloon angioplasty, vascular stent surgery, bypass surgery or other surgical interventions?

In general, you should start EECP extracorporeal counterpulsation therapy at least 6 weeks after surgery, while the wound has completely healed.

10. If I have high blood pressure, can I undergo enhanced extracorporeal counterpulsation (EECP) ?

If your blood pressure is under control, you can have EECP treatment. If your blood pressure rises continuously, it is recommended to consult a therapist first. When blood pressure is controlled, EECP treatment can be performed.

11. Can I undergo enhanced extracorporeal counterpulsation (EECP) if I have poor blood circulation in my legs?

Enhanced extracorporeal counterpulsation (EECP) promotes blood circulation throughout the body, including the extremities. However, if you have severe obstruction of blood flow to your legs, you may not be a candidate for EECP treatment. If your toes are blue/black or you lose sensation in your lower extremities, it is recommended to consult a therapist first.

12. If I use a pacemaker, can I undergo enhanced extracorporeal counterpulsation (EECP) ?

Some pacemakers may affect the EECP instrument to synchronize with the heartbeat. However, single-chamber pacemakers are generally acceptable.

13. Is there an age limit for enhanced extracorporeal counterpulsation (EECP) ?

There is no age limit. However, minor users need to obtain the consent of their parents or guardians before undergoing EECP treatment.

14. How do I feel during the EECP treatment? Will I feel discomfort or pain?
  • Pressure and Squeezing Sensation: During each cardiac cycle, pressure cuffs placed around your legs, thighs, and buttocks inflate and deflate in coordination with your heartbeat. This creates a squeezing sensation that may feel like a firm pressure moving up from your lower body towards your heart.

  • Warmth or Tingling: Some people may feel warmth or tingling sensations in their legs during the inflation and deflation of the cuffs. This is due to increased blood flow to the lower extremities. 

15. Can I pause or stop treatment mid-course?

OK. You can tell the operator at any point during the treatment that you want to stop the treatment. EECP counterpulsation also has an emergency stop button that can be used if you urgently need to stop treatment. It is recommended to go to the toilet before each treatment to facilitate the smooth progress of the treatment process.

16. How will I feel after the treatment?

Due to increased blood circulation, within an hour or two after treatment, reactions such as flushing, fever, and slight flushing may occur, as if you had just finished exercising. Individual users will feel refreshed; Some may experience mild dizziness and headache due to blood circulation or lack of hydration, but only temporarily.

17. How many sessions are there in the whole session?

For the treatment of chronic stable angina, the standard course of treatment is 35 treatments (5 times a week) over 7 weeks. For other treatments, the therapist should advise them on a case-by-case basis.

18. How long is each session?

For the treatment of chronic stable angina, the standard treatment time is 60 minutes each. For other treatments, the therapist should advise them on a case-by-case basis.

19. How many treatments do I need to perform to feel improvement?

The actual effect varies from person to person. Most people already feel a slight improvement after the first session, and the results become more pronounced as the course of treatment continues.

20. What happens if I miss a treatment?

While missing a treatment won't have much impact, it's recommended that you book your next treatment as soon as possible. Regular treatment is more effective.

21. Can I exercise during the weeks of enhanced extracorporeal counterpulsation treatment? Should it be before or after treatment?

Of course. You can exercise before or after EECP extracorporeal counterpulsation treatment.

Clinical studies have shown that EECP treatment improves exercise capacity in patients with angina. For athletes, EECP therapy can speed up recovery after exercise because it can enhance blood circulation and help remove metabolites such as lactic acid.

22. How long will the results last after completing the entire treatment?

Clinical studies have shown that the effect can last up to 5 years in some patients.[5]

23. Why is the effect of enhanced extracorporeal counterpulsation therapy (EECP) so long-lasting?

EECP treatment helps new angiogenesis, allowing blood flow to bypass blocked blood vessels and unimpeded delivery of oxygen and nutrients to the heart and organs.[6]

EECP treatment produces nitric oxide (NO) and reduces endothelin-1, which helps vasodilate and soften. The study found that 3 months after completing EECP treatment, participants remained significantly above baseline for nitric oxide (+12%) and endothelin-1 was still significantly below baseline (-11%). [7]

24. Can I continue the enhanced extracorporeal counterpulsation therapy (EECP) after completing the full course of treatment?

OK. Many people choose to continue EECP treatment after completing the full course of treatment in order to stay healthy.

Reference data :

[1] Medical Advisory Secretariat. Enhanced External Counterpulsation (EECP): An Evidence-Based Analysis. Ont Health Technol Assess Ser. 2006; 6(5):1-70. Epub 2006 Mar 1.

[2] Lawson, W.E., J.C. Hui, and P.F. Cohn, Long-term prognosis of patients with angina treated with enhanced external counterpulsation: five-year follow-up study. Clin Cardiol, 2000. 23(4): p. 254-8.

[3] Feldman, A.M., et al., Enhanced external counterpulsation improves exercise tolerance in patients with chronic heart failure. J Am Coll Cardiol, 2006. 48(6): p. 1198-205.

[4] Loh, P.H., et al., Enhanced external counterpulsation in the treatment of chronic refractory angina: a long-term follow-up outcome from the International Enhanced External Counterpulsation Patient Registry. Clin Cardiol, 2008. 31(4): p. 159-64.

[5] Lawson, W.E., J.C. Hui, and P.F. Cohn, Long-term prognosis of patients with angina treated with enhanced external counterpulsation: five-year follow-up study. Clin Cardiol, 2000. 23(4): p. 254-8.

[6] Caceres J, Atal P, Arora R, Yee D. Enhanced external counterpulsation: A unique treatment for the “No-Option” refractory angina patient. J Clin Pharm Ther. 2021 Apr; 46(2):295-303.

[7] Braith RW, Conti CR, Nichols WW, Choi CY, Khuddus MA, Beck DT, Casey DP. Enhanced external counterpulsation improves peripheral artery flow-mediated dilation in patients with chronic angina: a randomized sham-controlled study. Circulation. 2010 Oct 19; 122(16):1612-20.