Enhanced External Counterpulsation (EECP)

A non-invasive solution for patients with angina and congestive heart failure

EECP was developed for patients with angina and congestive heart failure. It is a safe, non-invasive, clinically proven outpatient treatment that may relieve or eliminate angina by increasing the heart’s circulation and, consequently, bringing more oxygen to the heart. Clinical studies have found that EECP creates a natural bypass around blocked or narrowed portions of the arteries. Benefits include reduced or complete elimination of chest pain, increased exercise tolerance, less use of medication and the ability to enjoy a more mobile and independent lifestyle.

Who is a candidate for EECP?

Your physician can evaluate you to determine if EECP may help you. You may be a candidate if you:

  • Have chronic stable angina
  • Do not receive adequate relief from angina by taking nitrates
  • Do not qualify for invasive procedures
  • Have tried invasive treatments without lasting relief
  • Want to explore alternatives to bypass surgery or angioplasty

What happens during treatment?

You will lie on a padded treatment bed while the therapist applies a series of cuffs, similar to blood pressure cuffs, around your calves and lower and upper thighs. The therapist also will apply electrodes to your chest and a sensor to your finger. These record your heartbeat and blood pressure.

The cuffs are timed to inflate when the heart is resting (diastole) and deflate when the heart pumps (systole). This encourages more blood and oxygen to circulate up around the heart. Patients often experience a sensation of a strong “hug” moving upwards from legs to thighs to buttocks during inflation, then a rapid release during deflation.

Most patients attend one-hour treatment sessions once a day, five days a week, for seven weeks.


Typical benefits of EECP include:

  • Symptomatic relief of angina unresponsive to medical therapy
  • Improved blood flow to deprived areas of the heart muscle
  • Eliminated or reduced need for nitrates
  • Improved tolerance for exercise

In a three-year follow-up study, the majority of patients remained free of angina, showed lasting improvements in their thallium scans and reported greater ability to engage in daily activities.

Is there a risk?

EECP carries little or no risk and is relatively comfortable. To ensure your treatment goes smoothly, follow the pre-treatment instructions provided by your technician.