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How does EECP Work?

May 1, 2013

How Does EECP Work?

External Counterpulsation Therapy (also known as ECP or EECP) is a non-invasive treatment for improving circulation in the heart for patients who suffer from narrowed and blocked arteries in the heart. This is a medical condition known as Coronary Artery Disease (CAD). When the blockages limited the flow of adequate blood to heart, patients can experience symptoms of chest pain or known in the medical community as angina pectoris. EECP Therapy is a rehabilitative process to restore a more adequate blood supply by stimulating growth of collateral vessels in the coronary arteries.

Concept of External Counterpulsation Therapy

ECP increases return and oxygen delivery to the heart. The amount of blood pumped by the heart each minute depends on the blood flow into the heart. The body returns used blood to the right atrium through a network of veins. The returned blood circulates through the heart and is pumped by the left ventricle into the aorta and systemic arteries. Increasing venous return, or blood volume , increases the pressure within the left ventricle (preload).

In a compliant heart, this increases stroke volume and cardiac output. Cardiac output is typically controlled by venous return. This rule does not apply to CHF patients. This principle is based on Frank-Starling’s Law pertaining to the heart. Frank Starling’s Law states that as the volume of blood entering the heart increases, the chamber walls will stretch to compensate. In a normal heart, the cardiac muscle then contracts with increase d force to compensate for the extra blood volume.

Supply and Demand of Blood Flow in the Heart

The heart has two primary phases of physical function known as systole & diastole. Diastole refers to the period of the cardiac cycle when the heart is at rest. During diastole, the chambers of the heart relax and fill with blood. At this time, the myocardium is supplied with blood and oxygen (perfusion). As perfusion pressure and blood volume increase the supply of oxygen to the myocardium will also increase.

ECP and EECP Therapy delivers external pressure to improve myocardial perfusion by significantly raising diastolic (filling) pressure. Increasing cardiac preload also increases coronary perfusion. When the contraction and/or volume of blood in the left ventricle increase, the rate of coronary blood flow also increases.

The Benefits of ECP Therapy also reduce myocardial oxygen demand by reducing the workload of the heart. This is achieved through systolic unloading and afterload reduction. ECP works to
reduce the left ventricle’s afterload by creating a “vascular void” or decreasing systemic vascular resistance. The heart then does not have to work as hard to pump more blood out to the body.

For more information, visit Overview of ECP and EECP Therapy

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