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Enhanced External Counterpulsation Therapy

What is enhanced external counterpulsation?

Enhanced external counterpulsation (EECP) therapy is a procedure that uses blood pressure cuffs on your legs to treat angina (chest pain).

When is it used?

EECP therapy may be used if you still have chest pain after treatment with medicine, bypass surgery, or angioplasty.

The procedure may not help if you have:

  • blood pressure that stays high even with treatment
  • a fast heart rate
  • problems with blood flow in your legs
  • heart valve problems
  • heart failure.

How does it work?

How EECP works is not well understood. It is thought that EECP forces slightly more blood into the blood vessels supplying the heart. Over time, this causes more blood vessels to grow in the heart muscle. Because angina is caused by the heart muscle not getting enough blood, growth of more blood vessels helps relieve angina.

How do I prepare for the procedure?

  • You may be more comfortable if you wear athletic tights or bicycle pants that don't bunch up under the blood pressure cuffs.
  • It’s a good idea to urinate before the procedure.
  • If you take diuretics, you might want to wait to take them until after the procedure.

What happens during the procedure?

Blood pressure cuffs are put on your legs. They are then inflated and deflated. The sequence of the inflation and deflation is timed with the beating of your heart.

You lie on a table with a blood pressure cuff wrapped around each calf. Two cuffs are placed around each thigh. The cuffs are connected to a device that inflates and deflates the cuffs, starting with the calf and moving up to the thigh, with each heartbeat. The procedure should not be painful.

Most people are treated for 1 hour a day, 5 days a week, for 7 weeks, but your healthcare provider may follow a different schedule.

What are the benefits of the procedure?

You may have less chest pain for many months or several years after EECP treatment.

What are the risks associated with the procedure?

There are few side effects or complications. You might have some irritation or bruising of the skin.


Written by Edward Havranek, MD, for RelayHealth.
Adult Advisor 2012.1 published by RelayHealth.
Last modified: 2010-12-10
Last reviewed: 2010-11-04
This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.
© 2012 RelayHealth and/or its affiliates. All rights reserved.
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