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ENHANCED EXTERNAL COUNTER PULSATION (EECP)
Click here to read our EECP Testimonials
We strongly suggest you read the following book by Debra Braverman called: Heal Your Heart with EECP.
It is an excellent resource book that outlines the full history of EECP, its applications, effects, indications and contraindications. For more information, visit Dr. Braverman’s website at: www.bravermancenters.com
You can also learn more at Vasomedical Inc’s website: www.vasomedical.com. They manufacture the EECP units and their web site has many references and resources.
Coronary Artery Disease
DO ANY OF THESE CONDITIONS APPLY TO YOU?
Congestive Heart Failure
Do you no Longer Respond to Your Medication?
Have you had Repeat Cardiac Procedures (bypass, stents, angioplasty)?
Are you Unwilling or unable to Undergo Invasive Surgery?
DID YOU KNOW THAT...
Heart disease and its consequences remains the number one killer in America. 13 million Americans suffer from heart disease. Fortunately, for most people suffering from heart disease and other systemic circulatory conditions, there is an alternative that is significantly less invasive and has been proven over and over again to be just as effective if not, even more effective than the other more invasive procedures. This treatment is called Enhanced External Counter Pulsation (EECP).
HISTORY AND BACKGROUND
EECP has been around since the 1950’s with research in counter pulsation being done at Harvard University. In the United Sates alone there are about 700 EECP units. It is approved by the FDA, and has been for almost 15 years, for the treatment of chronic stable angina, cardiogenic shock as well as during a heart attack. It is now additionally used as a treatment for several heart and circulatory conditions such as peripheral vascular disease, coronary artery disease, angina, as well as congestive heart failure. There are more than one hundred peer reviewed studies that show EECP’s effectiveness. In fact it has been shown to be at least as effective, if not, more effective than angioplasty, without the invasive surgery. It has been proven to be extremely effective and safe. There have been many multicenter, controlled, clinical studies conducted throughout the United States, India and China. At present EECP is being studied and used at many prestigious medical centers such as Rochester Medical Center, Heart Centers of America, University of California at San Francisco, Mayo Clinic, Harvard University and literally dozens of other medical centers throughout the United States and around the world.
EECP is a safe, non-invasive medical procedure used to correct peripheral circulatory disease and coronary artery disease. EECP works by increasing blood circulation to the heart and the rest of the body. It is a simple in-office procedure that is given daily, five times per week for seven weeks, at one hour per treatment (a total of 35 hours). There is no down time. The treatment consists of strapping blood pressure-type inflatable cuffs to the lower legs and thighs while the patient lies on the treatment table. During the relaxation phase of the heartbeat, the cuffs quickly inflate in sequential order from the lower legs to the upper thighs and buttocks. This causes counter flow of blood back through circulation and to the heart.
WHAT CAUSES HEART DISEASE
Our understanding of heart disease has increased in the last several years. Once thought to simply be a ‘plumbing’ problem, we now know that heart disease is much more than this. In fact, heart disease is not simply a disease of ‘blockages’ of the arteries of the heart (atherosclerosis) due to the build up of cholesterol inside the arteries. Only half of those who have a heart attack have elevated cholesterol. According to the New England Journal of Medicine (2002) C-reactive protein (CRP) is a better predictor of heart attack than cholesterol. The condition is a systemic one. You can be certain that if an individual has blockages in their heart, it is very likely that they will also have blockages in other parts of the body. Secondly, cholesterol is not the underlying cause of these blockages. There are several steps in the development of an arterial plaque. Simply stated heart disease begins with damage to the inner lining of the arteries. This damage can be mechanical, which can be caused by elevated blood pressure, chemical, as in smoking and uptake of other toxic chemicals, infection, elevated free radicals, and others. The result of this damage is inflammation. The inflammatory response is the response of the body as it attempts to ‘fix’ the damage. Besides inflammatory white blood cells, oxidized cholesterol, calcium and platelets deposit in the area to further aid in repair. Over time a fibrous sheath is laid down over the plaque to wall of this damaged site. Over many years the plaque grows larger and larger progressively blocking blood flow through the artery. Arteries can be blocked in the range of 70% before an individual may feel any symptoms at all. Further, when the plaque becomes weak over time, a piece of inflammed, fatty plaque “erupts” from the artery wall. Upon rupture, the internal lining ‘bleeds’. Platelets stick together at the site of rupture, forming a thrombus (blood clot). This is the clot that we know to ‘block’ the artery. The block and subsequent decrease in blood flow, is the cause of angina and in other cases myocardial infarction (heart attack). Traditionally, coronary bypass surgery, stents and angioplasty have been the treatments of choice for this situation. Almost 2 million of these procedures are performed annually. Though some benefits of these procedures are obvious, they do not treat the underlying cause and are very invasive and therefore do carry significant risk.
Fortunately, the body has an amazing ability to adapt to this situation by creating new pathways of blood flow around the blockage. This is called collateral circulation and it is the basis of EECP therapy.
HOW DOES EECP WORK
During EECP therapy blood pressure type cuffs are placed around the calves, thighs and buttocks. As your heart enters its relaxation phase of the heartbeat (diastole) the cuffs sequentially inflate from the lower legs to buttocks, to a pressure of 260 mmHg. This action increases the blood flow back to the heart by 28%. The counter pulsation of blood to the heart increases the strength of contraction of the heart and therefore cardiac output. As the cuff pressure increases so too does the volume of blood to the heart and thus cardiac output even further. It is a linear relationship. This also increases and strengthens circulation throughout the body. As you can imagine the increase in blood flow through circulation will increase the delivery of oxygen and nutrients to the heart muscle and throughout the body.
Our bodies have the natural ability to develop newly functioning arteries. Each person has small arteries that are not contributing to regular blood flow because they are not needed. However when there is a blockage in an area these non-functional arteries will “develop” around the block to ensure oxygen and nutrients to the area. This process is referred to as collateral anastomosis. The force against the lining (endothelial) of the arteries created by EECP increases the production of vascular endothelial growth factor (VEGF), a chemical that stimulates new blood vessels to grow and mature. VEGF is increased by 21% following a single 60 minute treatment.
EECP therapy further decreases pro-inflammatory white blood cells and promotes dilation and relaxation of the arteries through production of nitric oxide. Nitric oxide also strengthens the inner lining of arteries thereby protecting them from damage. EECP also decreases a chemical called endothelin. This chemical has several damaging effects on cardiac health. First, it causes constriction of blood vessels and therefore decreased blood flow. This causes the heart to work harder in order to overcome the increased vascular resistance. Endothelin also causes an increase in blood pressure since it increases aldosterone and atrial natriuretic peptide which both cause salt retention and therefore water retention. This of course is a very important cause of congestive heart failure and major risk factor for a heart attack.
As the heart enters the contraction phase of the heartbeat (systole), the cuffs quickly deflate, decreasing the resistance of blood circulation through the body. This helps to decrease the workload of the heart. In short, EECP therapy increases blood flow to the heart muscle. Some compare EECP therapy to passive exercise for the heart.
Step 1 Inflation initiates retrograde pulse wave
Step 2 Inflation of lower thigh cuffs-50ms later
Step 3 Inflation of upper thigh cuffs-50ms later
Step 4 Deflation facilitates cardiac unloading
The clinical outcomes show a reduction or elimination of angina, reduced nitroglycerine use, greater exercise tolerance, more energy, increased libido, and better emotional outlook.
Nobody has ever died as a consequence of this procedure. Other than mechanical wear and tear on a person’s legs, there has not been any serious complications or adverse effects from the treatment. It does not cause stroke or induce heart attacks. As noted above, EECP has been FDA approved for use during a heart attack.
Almost every person is a candidate for EECP. However there are a few exceptions. Some of the contraindications are relative (case by case) and not absolute. Before EECP therapy is prescribed, a case history, physical exam and special testing are required to determine a person’s candidacy for treatment. The following are contraindication and relative contraindications to EECP therapy:
Uncontrolled hypertension (above 180/110)
Severe aortic insufficiency
Abdominal aortic aneurysm
Individuals with current blood clot in the deep veins of the leg (DVT).
Open wound (relative)
Bleeding disorders (relative)
Even though this remarkable treatment has been around for decades and used throughout the world, it is not well known in Canada. In fact, in Canada, EECP is only available in Ottawa, Toronto, Brampton, and now Kamloops. Yes, we are the only clinic west of Toronto who offers EECP therapy.
If you have any questions, please feel free to contact our office at 250-377-3077.
"I wouldn’t be here today if it wasn’t for my EECP treatments as I’ve had congestive heart failure for the last few years. Prior to EECP, I couldn’t even get a meal ready or understand what I was reading. After the treatments, my mind was alert and I was able to better retain information and focus on tasks. EECP also improved my sleep, energy, digestion and ability to walk. I would recommend EECP therapy to anyone who has cardiovascular disease. Do not put this treatment off any longer!"
Rita C., 89 years old
"I had a massive heart attack Thanksgiving - Oct.,2008. I was airvact from 100 Mile House hospital to Van. Gen. Hosp. where I underwent an emergency angioplasty. The doctors removed the blood clot that was causing a total blockage and great pain. They took several days to decide what protocol to use re. the other blockages: 60% stent, 80% stent, 80% stent, 80% stent large – they left: one 60%, two 50%, two 30%, and three 20% - 12 blockages in all. The first echo report after the attack showed a mod. LV dysf'n with an EF of 35% (the heart only works at 60% max. apparently). I had my second echocardiogram at VGH, Feb., 2009, which showed mild to moderate LV dysf'n with an EF of 35 – 40%. A year later I was in distress – couldn't get air – couldn't walk without tiring – had trouble sleeping – developed a cough – had swelling of the ankles and lower legs. I found myself at the ER in Kamloops hosp. March 2010, where they did another echocardiogram – mild conjestive heart failure with an LVEF of 30%. All the symptoms mentioned above became ascaserbated as time went on. I researched CFH and learned that the prognosis of patients with conjestive heart failure wasn't good according to the status quo using their standard of care.
None of the protocols my G.P. and Cardiologist used were helping – obviously. I decided to see Steve. He had offered me EECP when he first got it. I began my treatment in August 2010. I still had fluid retention, so on his advice I saw a local ER M.D. who put me on some medication (which I am now weaning off). Due to the distance, I went to the clinic 3 days a week for 2 hrs. each day (35 hrs. total). Not even mid way through I felt a difference – by the end of the treatment late Sept. I felt amazingly well – better than I had felt in years. In fact, I hall one ton of 60lb. hay bales at a time – load them at the hay growers and unload and stack them in my hay shed......no trouble at all. I sleep like a baby. Life is wonderful. Dec. 2010, I went in to the medical clinic to request another echocardiogram. The doctor (new) listened to my heart and said it sounded really strong and my blood pressure was excellent (white coat syndrome and all). It will be interesting to see what the results will show on the echo. Plus... the M.D. is interested in EECP. I feel they all should be. After I get the results my wife and I want to present my case to our local MP and MLA. This procedure should be available through our MSP and all health care professionals should know about and understand EECP. It was a life saver for me!
If anyone feels they want to contact me regarding my case, please let Steve know."
Michael G., 70 years old