External Counter Pulsation Treatment

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

-What is ECP?

 

External Counter Pulsation (ECP) is performed as a non-invasive treatment to lower the number and intensity of angina episodes.  Treatment is administered through three pairs of external inflatable cuffs that are applied around the lower legs, upper legs and buttocks.  These cuffs continuously inflate and deflate between the resting period of the heart beat and increase blood returned to the heart.

 

The basic principle of ECP treatment involves increasing the amount of blood returning to the heart, which helps supply more oxygen to its starved areas.  With more oxygen available, the heart can function much more efficently and therefore, reduce chest pain.

 

The treatment shcedule includes 7 weeks of continuous treatments which require daily visits for 1 hour, Monday through Friday.

 

-History of ECP Treatments

ECP treatment originated in China where it has been extensively used since the 1960's.  In the past ten years it has been introduced to the United States,where there are currently around 1200 machines in operation.  The idea for ECP, stemmed from the development of the intra aortic balloon pump(IABP). IABP resulted in increasing the amount of blood that you can get pumped out of the heart by inflating a balloon in the aorta between each heart beat.  Opening up the aorta allows more blood flow and therefore decreaced how hard the heart has to work.  This same theory is applied to ECP but is taken one step further.  ECP increases the amount of blood going back to the heart, providing more blood for the heart to work with.  This also decreases how hard the heart has to work but on a much greater scale, especally for people with damaged heart tissue.

 

-Who is Eligable for ECP Treatment?

Individuals are eligible for treatment if they have:

 

• Had coronary artery bypass (CABG) or stents placed in the coronary arteries with ongoing angina.

• Had no prior bypass or stenting but continue to suffer from angina.

 

-Contriandications:

1. Hypertropic cardiomyopathy  4.Enlarged heart    7.Atrial fibrillation              10.Severe elevated blood pressure

2. Congenital heart disease         5.Pacemaker           8.Pulmonary hypertension  11.Heart rate >120 bpm

3. Valvular disese                        6.Hemorrage          9.Clot in their body

 

-What are the benefits of ECP treatment?                                                                                 

• Increased oxygen supply for the heart

• Decrease in chest pain

• Improved EKG response to exercise

• Decrease in Nitroglycerin use

• Increase in energy

• Increase in exercise duration

• Long term effects up to 2 years

 

 

-ECP Program Overview                                 Before ECP                   After ECP                           

Before begining ECP treatment:                                                               

• Physcian referal obtained

• Pre-treatment appointments:

1. Nursing assesment

2. Stress test

3. Orientation to procedures and equipment

 

-Nursing assessment

The nursing assessment will include a review of medical history, contriandications to treatment and clearing the individual for treatment.  During this assessment they will be given an agina diary which will be used to record frequency and duration of chest pain episodes.  During the nursing assessmsnt, the indivdual will receive comprehensive information about ECP treatment, its procedures and will complete several questionaires to assess severity of chest pain.

 

After completing 35 treatment sessions, there will be another sterss test measuring the same values.  The two stress test will be compared which will indicate any changes in chest pain and exercise capacity.

 

-Orientation

The orientation is designed to give an individual the chance to experience exactly what treatments will be like.  There will be an orientation to the room, a full explanation of the treatment sessions, education about the treatment process, and a 15 -minute trial of ther ECP machine operation.  Any questions about the treatment will also be addressed at this time.  The first offical treatment will be begin the next day at a specified time.