Almost everyone perceives heart bypass surgery as an invasive procedure since it involves cutting your chest open and doctors repairing the defects of the heart. Many times, medicine and technology interplayed to minimize the risk. Through extensive studies and trials, it has been suggested that a new, non-invasive procedure known as EECP or Enhanced External Counter-Pulsation is already out and about for cardiac patients to avail. Let us take a walk-through the entirety of the procedure and see for ourselves if it has become genuinely an alternative to a heart bypass.
Enhanced External Counter-Pulsation (EECP) is a non-invasive clinical treatment that concentrates on increasing heart blood flow. It uses inflatable cuffs which are placed around the buttocks, the calves, and the thighs. These cuffs inflate according to the patient’s heartbeat and increase the blood flow towards the heart. The principle involved in this treatment is incrementing the volume of venous return to the heart which then increases the oxygen levels in areas with low oxygen supply. The more the oxygen supply, the better the overall functionality of the heart will be.
EECP is said to have been preconceived in China since the late 20th century. A decade ago, it was introduced in the United States. Its use escalated that over 1200 operating machines are available for therapy. EECP originated from the concept of IABP or intra-aortic balloon pump yet more advanced. The dynamics of the latter procedure involve increasing blood volume that is being pumped away from the heart through balloon inflation in the aorta through heartbeat synchronization. Hence, it decreases the workload of the heart and increases blood flow.
The same theory applies to the Happy Heart EECP. However, it does not only increase the blood volume away from the heart but also increases the blood flow that is going back to it. This provides the heart ample amount of blood to work with which decreases its workload. This is primarily beneficial for those people who have damaged cardiac tissue.
EFFECTIVITY AND ADMINISTRATION
Some of the studies suggest that EECP can somehow be an effective treatment for chronic stable angina. Albeit the need for larger respondents to prove the effectiveness of this treatment fully, a small random trial has shown that there was a significant improvement in both the symptoms and the exercise tolerance of the coronary artery disease (CAD) patients. Also, EECP has improved the measures of quality of life among its patients in comparison to placebo therapy. Other studies claim that there was a symptomatic improvement that lasts up until five years for those who had followed the EECP course.
On the other hand, the administration of EECP is on an outpatient basis. The patient receives a one-hour session for five days. The treatment shall last for seven weeks. This total of 35-hour sessions aims to create lifelong beneficial changes in the cardiovascular system.
INDICATIONS AND CONTRAINDICATIONS
This non-invasive procedure is clinically indicated for those patients who had undergone CABG or coronary artery bypass. This is also for those who have no prior bypass or those patients that have stents placed in the coronary artery and still suffer angina.
However, it is contraindicated for those patients who have recently undergone cardiac catheterization to reduce the possibility of femoral puncture site bleeding. Arrhythmia might inhibit the system triggers. Congestive heart failure that is uncontrolled may lead to unloading in the left ventricle which is insufficient to recompense for the increase in blood flow during the EECP. Furthermore, aortic Insufficiency involves regurgitation which can prevent augmentation in the diastole. A severe blood clot in the body can reduce the effectivity of counter-pulsation. High blood pressure, that is not less than 180/110 mm Hg, can induce risks during EECP since it is capable of producing high diastolic blood pressure levels. Lastly, patients, who are under warfarin therapy because of bleeding diathesis, cannot undergo EECP because intramuscular bleeding might happen due to cuff pressure.
PROS AND CONS
EECP poses several benefits to the heart. For one, during diastole, the cuffs on the lower body increase arterial blood flow towards the coronary artery. The coronary artery receives blood flow between heartbeats and not during each heartbeat unlike the other arteries. Also, the synchronization between the patient’s heartbeat and cuff deflation creates a vacuum-like action in the arteries which reduces heart workload. Other benefits include reduced chest pain, improved heart electrical activity, reduced use of nitroglycerin, increased stamina and energy. Its long-term effects may last up to 2 years if you are religious with the prescribed treatment session.
Although it may seem picture-perfect, some experts claim that this procedure has also its downsides. Some cardiologist thinks that the procedure is peculiar and difficult to explain. Also, a study from the National Institute of Medicine regarded EECP therapy as very time-consuming. Even if EECP may have shown improvement in most of the angina patients, it is not viable as a permanent substitute for bypass surgery. A clinical discussion between Dr. Andrew Weil and Dr. Stephen R. Devries said that EECP is not indicated for patients who have multiple and severe arterial blockages in the heart. This treatment is only recommended for those patients who are not surgical candidates.
Overall, Enhanced External Counter-Pulsation (EECP) can still help treat chest pains (angina), but it cannot be fully considered as a substitute for heart bypass because of its very limited scope in therapy. It still needs further study and innovation for the medical society to get a good grasp of its dynamics and eventually introduce such advancement to the community.
However, let us not forget that there is no greater substitute for natural ways of taking care of our health through diet, exercise, and mindfulness of mental and psychological well- being. Even if science consistently introduces new bouts of advancement in medicine, we should be wary not just on our food intake but also on the environment that gets through us. It’s a matter of having the right attitude and perspective about our overall well-being because, after all, health is wealth.