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External counter pulsation therapy

External counter pulsation therapy

External counter pulsation therapy


ECP stands for External Counter Pulsation. It is an effective treatment for a form of angina called Chronic Refractory angina. This means that despite optimum medication and surgical intervention, a patient may still suffer from angina pain.


ECP works in a number of different ways. It reduces the resistance that the heart has to overcome before being able to pump blood to the body. This is known as afterload. It increases the amount of blood flowing through the coronary arteries during its resting phase (diastole), and increases the amount of blood returning to the right side of the heart.


ECP appears to exert its coronary artery effects by increasing the amount of pressure in a narrowed artery, thereby opening up collateral channels around a blockage such as atheroma in heart disease. It also has a mild exercise effect on the heart. Athletes have well established collaterals, due to the amount of exercise that they have to undertake and their general level of fitness.


Inflatable cuffs are placed around the calves, thighs and buttocks. A continuous ECG is taken of the heart and analysed. Inflation and deflation of the cuffs is rapid and timed precisely to the ECG or heart rhythm. Treatment consists of 35 one hour sessions. Research conducted at a leading American university hospital has established that 35 hours is the optimum treatment time for this therapy.


During its inception at the Wellington hospital, a research study was undertaken which also corroborated the previous findings. Most patients find that following completion of ECP, the amount of medication they need to take to control the angina pain is reduced significantly, with some able to cease nitrate spray completely. Exercise tolerance is also increased, with many patients reporting being able to resume activities that they previously had been unable to participate in.

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