What are the benefits of EECP over the conventional angioplasty or bypass surgery to treat angina and blockages?

For people who suffer from angina and have blockages in the heart a conventional way to treat the condition is to offer angioplasty which helps to widen the narrowed blood vessels and improve blood fl

By: Debjani Arora | | Published: May 12, 2018 1:17 pm

For people who suffer from angina and have blockages in the heart a conventional way to treat the condition is to offer angioplasty which helps to widen the narrowed blood vessels and improve blood flow and circulation or a bypass surgery. However, there could be people who might be unfit to undergo an angioplasty-like people who have obstructions in arteries that runs the entire length of the artery and is laden with fatty plaques. In these types of arteries opening up of a short segment through angioplasty is ineffective. Even if it is attempted the recurrence rates are very high. Also for people with repeated procedures, the chances of recurrence keep on increasing with every procedure. For such people, an alternative like EECP or enhanced external counterpulsation is suggested.

The proven benefits of EECP therapy are that the person with angina has a significant reduction in angina frequency (episodes of chest pain, shortness of breath, etc) which promises a better quality of life the proof of which is a sustainable exercise duration on the stress test. These effects are the same as expected after angioplasty. But there is no evidence that angioplasty can reduce heart attacks or improves life expectancy in people suffering from stable ischemic heart disease (where the arteries of the heart are damaged). The only difference may be that angioplasty takes ½ hr to 1 hr and results show early whereas EECP, on the other hand, takes three to six weeks to complete and the effects are slow. In one of the latest studies, there were no significant benefits after angioplasty as compared to medical therapy.

The side-effects

If people for the procedure are chosen correctly, there are practically no side effects of EECP. People with significant leakage of the aortic valve, PDA, leg vein clotting; leg ulcers should not be taken up for the therapy. High BP and leg swelling due to heart failure should be adequately controlled before therapy. Some people with soft skin can experience mild abrasions in the legs. As EECP therapy stimulates lower limb muscles some people who are absolutely untrained for exercise may experience leg cramps for a few days.

Criteria

The EECP therapy can be given to people irrespective of age, sex and gender. However, the pressure of the cuffs may have to be adjusted according to individual tolerance levels.

Duration

The treatment of EECP is outdoor treatment, does not require admission to the hospital. It requires 35 sessions of one hour each. The therapy may be done maximum 2 times in a day at an interval of 2-3 hrs. This way the whole treatment lasts for 3 (twice daily) or 6 (once daily) weeks.

Cost involved

The whole treatment costs one lakh fifteen thousand inclusive of 35 sessions and all interim evaluations. This is still ½ to ¼ of the price of angioplasty or bypass surgery.

What to expect

The biggest truth of ischemic heart disease (where the blood vessels of the heart are damaged) is that it is ultimately a ‘lifestyle disease’ i.e., majorly a product of faulty lifestyle. Angioplasty, bypass surgery or even EECP are at best temporary arrangements to improve circulation to heart muscle supplied by the obstructed artery. The art of long-term sustenance of benefits and clear arteries lies in maintaining regular exercise, diet control, control of BP, diabetes, cholesterol through appropriate medications and tobacco cessation.

Image source: Shutterstock

Published : May 12, 2018 1:17 pm

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