EECP: Enhanced External Counter Pulsation (EECP) is performed as a non-invasive treatment to lower the number and intensity of angina episodes. It is a mechanical procedure in which long inflatable cuffs (like blood pressure cuffs) are wrapped around both of the patient’s legs. While the patient lies on a bed, the leg cuffs are inflated and deflated synchronously with each heartbeat.

The inflation and deflation are controlled by a computer, which uses the patient’s electrocardiogram (ECG) to trigger inflation early in diastole (when the heart relaxes and is filled with blood), and deflation just as systole (heart contraction) begins. The inflation of the cuffs occurs sequentially, from the lower part of the legs to the upper, so that the blood in the legs is “milked” upwards, toward the heart. EECP also may improve peripheral arterial function, which serves to reduce myocardial oxygen demand

Overall, EECP has been proven to be the safest therapy, as a survey by the International EECP patient registry (IEPR). Of 2500 patients treated, 0.3% died, 0.9% had a myocardial infarction, 0.2% had bypass grafting, and 0.8% had percutaneous coronary intervention (PCI) during the treatment period.