India External Counter Pulsation Therapy (ECP) !

External Counter Pulsation (ECP) is a cardiac care therapy that provides relief from angina pectoris (severe chest pain) without surgery or medication. The ECP technique was pioneered in the U.S. in the 1950s, then developed, refined, and widely used in Asia while western physicians turned to a variety of surgical procedures. With the reintroduction of ECP to the U.S. in the 1980s, doctors and patients finally saw a low cost, low risk therapeutic alternative to surgical or chemical intervention.

ECP is a simple, non-invasive, non-pharmacological, low risk, painless therapy that can be provided to a patient at a fraction of the cost of surgical alternatives!

Clinical trials have confirmed the benefits of ECP treatment. They include: symptomatic relief of angina unresponsive to medical therapy, improved blood flow to deprived areas of heart muscle demonstrated by the results of thallium stress testing, elimination or reduction of nitrate use, improved ability to exercise.

In a 3-year, follow-up study, the majority of patients remained free of angina and showed persistent improvements in their thallium scans. Patients and their families usually report noticeably greater ability to engage in daily activity.

A computer interprets the patient's ECG and provides timing signals that control the sequential inflation and deflation of balloon pressure cuffs wrapped around the extensive vascular beds of the patient's calves, thighs, and buttocks. Each inflation cycle is timed to start and end during the resting phase of the patient's heartbeat (diastole).

As diastole begins, the cuffs inflate rapidly and sequentially from the calves to the buttocks, firmly compressing the patient's vasculature. This has two immediate effects: One, a strong retrograde "counter-pulse" occurs in the arterial system, forcing freshly oxygenated blood back toward the heart and the coronary arteries. And Two, an increased volume of venous blood is returned to the heart under increased pressure. The combined effect of these two events is to increase the oxygen supply and perfusion pressure in the myocardium (heart muscle) and to increase "pre-load" so the heart has a greater volume of blood to pump during the next systolic event.

Next, as the patient's heart nears the end of diastole and prepares for systole (ventricular contraction), the computer instructs the deflation valves to open with a vacuum which deflates the cuffs better and quicker and instantly. This action also provides therapeutic advantages by reducing the heart's after-load. Since the vascular beds in the lower extremities are essentially empty, the resistance to blood flow is markedly reduced, thereby decreasing the amount of work that the heart must do to pump blood to these areas (reducing oxygen demand within the myocardium).

As a result of these diastolic augmentation activities, the patient's peak diastolic pressure is significantly increased, benefiting circulation in the heart muscle and in other organs as well. At the same time, the patient's systolic pressure is reduced, to the general benefit of the vascular system.

Advantage for Patients - 35 hours of treatment cost as little as one-fourth to one-sixth the cost of invasive surgery…without any of the risk. Per-treatment costs may vary by office or region. In USA the procedure is eligible for reimbursement by Medicare, most private insurance, or direct billing by the physician. The patient does not have to give up work or other normal daily activities for a lengthy hospital stay and recuperation time.
Mediescapes India
"Technology for treating cardiovascular disease is slowly moving from very invasive to less invasive methods. In the seventies, bypass surgery was the big news in the treatment of coronary artery disease. In the eighties, it was balloon angioplasty and in the nineties, it was the stent. Now, we can move still a step further to a totally non-invasive treatment with ECP."

The patient relaxes on a comfortably padded mattress while a trained nurse or therapist wraps the muscular areas of the patient's calves, thighs, and buttocks with pneumatic cuffs, similar to blood pressure cuffs. Hoses connect the cuffs to an air pressure/vacuum pump enclosed within the bed base. Next to the bed is the computer-controlled operator's console. Three ECG electrodes are fastened to the patient's chest so the computer can monitor his or her heart rate. A plethysmograph sensor is placed on the patient's finger to detect the ebb and surge of each pulse wave.

When patients have angina, their bodies are telling them that their heart is not receiving enough oxygen. A treatment, in harmony with patients heart, can improve circulation to the heart muscle. ECP treatment appears to stimulate the opening of new, natural pathways around narrowed or blocked arteries. After ECP treatment, patients may find that:

++ they can walk farther, carry heavier packages, and be more
active without having angina.
++ they have fewer attacks of angina.
++ their episodes of angina are less intense.
++ they need less anti-anginal medication.
++ they can return to work, go out to dinner, garden, travel, or
enjoy golf, tennis, or bowling once again.
++ they no longer restrict their social lives, volunteer activities, or
exercise because they are worried that they will cause angina.

If patients are one of more than seven million people in the United States with angina, they may be all too familiar with angina. Angina signals that a part of the heart muscle is not receiving an adequate supply of blood and oxygen. The heart requires a particularly rich blood supply because of its heavy workload, and receives this nourishment through the coronary arteries. When these vessels are narrowed or blocked, restricting blood flow, they fail to supply adequate oxygen.

Then, while the patient relaxes and talks to visitors, watches TV or a video, listens to music, or even takes a nap, the operator starts the procedure and adjusts the machine during the hour-long procedure.

Studies conducted at numerous university medical centers and published in peer-reviewed medical journals have demonstrated benefits including:

++ elimination or decrease in exercise-induced signs of lack of
oxygen to the heart muscle (ischemia).
++ increased exercise tolerance .
++ elimination or decrease in episodes of chest pain.
++ decrease in need for anti-anginal medication

Spectramed Systems is the demonstration centre and training centre for doctors for the External Counter Pulsation device used for treatment of stable Ischaemic Heart disease.Our centre in Ludhiana, Punjab and is professionally managed by medical doctors.

India India External Counter Pulsation Therapy (ECP) FAQ's

What is ECP ?
External Counter Pulsation (ECP) is a cardiac care therapy that provides relief from angina pectoris (severe chest pain) without surgery or medication. The ECP technique was pioneered in the U.S. in the 1950s, then developed, refined, and widely used in Asia while western physicians turned to a variety of surgical procedures. With the reintroduction of ECP to the U.S. in the 1980s, doctors and patients finally saw a low cost, low risk therapeutic alternative to surgical or chemical intervention.
ECP is a simple, non-invasive, non-pharmacological, low risk, painless therapy that can be provided to a patient at a fraction of the cost of surgical alternatives!

How it works?
Clinical trials have confirmed the benefits of ECP treatment. They include: symptomatic relief of angina unresponsive to medical therapy, improved blood flow to deprived areas of heart muscle demonstrated by the results of thallium stress testing, elimination or reduction of nitrate use, improved ability to exercise.

In a 3-year, follow-up study, the majority of patients remained free of angina and showed persistent improvements in their thallium scans. Patients and their families usually report noticeably greater ability to engage in daily activity.

A computer interprets the patient's ECG and provides timing signals that control the sequential inflation and deflation of balloon pressure cuffs wrapped around the extensive vascular beds of the patient's calves, thighs, and buttocks. Each inflation cycle is timed to start and end during the resting phase of the patient's heartbeat (diastole).

As diastole begins, the cuffs inflate rapidly and sequentially from the calves to the buttocks, firmly compressing the patient's vasculature. This has two immediate effects: One, a strong retrograde "counter-pulse" occurs in the arterial system, forcing freshly oxygenated blood back toward the heart and the coronary arteries. And Two, an increased volume of venous blood is returned to the heart under increased pressure. The combined effect of these two events is to increase the oxygen supply and perfusion pressure in the myocardium (heart muscle) and to increase "pre-load" so the heart has a greater volume of blood to pump during the next systolic event.

Next, as the patient's heart nears the end of diastole and prepares for systole (ventricular contraction), the computer instructs the deflation valves to open with a vacuum which deflates the cuffs better and quicker and instantly. This action also provides therapeutic advantages by reducing the heart's after-load. Since the vascular beds in the lower extremities are essentially empty, the resistance to blood flow is markedly reduced, thereby decreasing the amount of work that the heart must do to pump blood to these areas (reducing oxygen demand within the myocardium).

As a result of these diastolic augmentation activities, the patient's peak diastolic pressure is significantly increased, benefiting circulation in the heart muscle and in other organs as well. At the same time, the patient's systolic pressure is reduced, to the general benefit of the vascular system.

Quick description of the procedure ?
The patient relaxes on a comfortably padded mattress while a trained nurse or therapist wraps the muscular areas of the patient's calves, thighs, and buttocks with pneumatic cuffs, similar to blood pressure cuffs. Hoses connect the cuffs to an air pressure/vacuum pump enclosed within the bed base. Next to the bed is the computer-controlled operator's console. Three ECG electrodes are fastened to the patient's chest so the computer can monitor his or her heart rate. A plethysmograph sensor is placed on the patient's finger to detect the ebb and surge of each pulse wave.

Then, while the patient relaxes and talks to visitors, watches TV or a video, listens to music, or even takes a nap, the operator starts the procedure and adjusts the machine during the hour-long procedure.

Why it works ?
The goal of ECP is to encourage cardiac circulation to bypass blockages and restore ischemic areas of the heart muscle. Clinical studies suggest that the increase in myocardial perfusion pressure stimulates the use of collateral vessels that are already present, but unused, thereby allowing oxygenated blood to bypass ischemic (starved) areas in the heart. A supplemental hypothesis that is backed by clinical indicators suggests that the myocardium may also develop new vasculature.

Who it works for ?
For many angina sufferers, ECP therapy may be a preferred alternative to bypass surgery, angioplasty, stenting, or medication. At present, the FDA has cleared NICORE to market the NCP-1 for treatment of stable angina pectoris, but independent studies of ECP are underway to expand usage to treat other conditions, such as congestive heart failure.

Ask your doctor if ECP is right for you. ECP may be indicated for patients who have already had, or are not good candidates for, surgical intervention. It is often an ideal choice for stable angina patients with single or multiple vessel coronary artery disease. In some cases, patients may be able to improve coronary circulation and perfusion pressure before a scheduled bypass surgery. The treatment is also useful for patients who do not tolerate, or who prefer not to rely on, medication.

ECP may be contraindicated for patients with certain conditions, including: recent surgical intervention, uncontrolled arrhythmia, pacemaker, severe pulmonary disease, congenital heart defects, severe hypertension, aneurysms, pregnancy, or the presence of a burn, open wound, or fracture on any limb subject to ECP treatment. A prescription from a licensed physician is required for ECP treatment.

What are the benefits ?
Studies indicate that nearly 80 percent of angina sufferers benefit from ECP treatment. Most patients report that after the full course of treatment their angina symptoms are reduced or eliminated and they have a greater tolerance for exercise. Their social activities are no longer restricted and their dependence on anti-angina medications is lessened or eliminated.

In addition to the subjective benefits of a more active lifestyle, ECP has been shown to provide long-term relief from angina symptoms. Although it is difficult to forecast how long the effects of ECP will last in an individual patient, studies show that the majority of patients sustain their ECP benefits for as long as 3-5 years (often longer than angioplasty or bypass grafts).

ECP therapy also provides a range of objective benefits that a physician can use to determine the effectiveness of treatment. Benefits are easily measured by response to exercise stress testing and radionuclide imaging. (For example, Thallium 201 imaging can clearly depict the increase in perfusion to previously ischemic areas of the heart.)

What are the clinical benefits of treatment ?
ECP treatment can reduce or eliminate the frequency and intensity of chest pain, decrease the need for medication, and greatly improve the ability to participate in activities of daily living. After receiving ECP treatment, patients often are able to enjoy moderate exercise for the first time since developing angina. ECP treatment can reduce or eliminate the frequency and intensity of chest pain, decrease the need for medication, and greatly improve the ability to participate in activities of daily living. After receiving ECP treatment, patients often are able to enjoy moderate exercise for the first time since developing angina.
Mediescapes India
What's Angina ?
Angina literally means "strangling in the chest". It is the most common symptom of coronary artery disease, which occurs when vessels that carry blood to the heart muscle become narrowed and blocked by deposits of calcified fatty tissue (atheroma).

Is Angina life threatening ?
Angina signals heart disease, the number one killer in the industrialized world. Two to four percent of people with angina die from heart disease. More than 7 million people in the United States suffer with angina. An estimated 350,000 new cases occur each year. Of this number, approximately 1 million will have invasive procedures; 6 million patients who are maintained on drug therapy live in varying degrees of discomfort. Angina is frequently crippling and disabling; patients are often unable to maintain their lifestyles.

What does it feel like ?
The majority of patients with angina complain of chest discomfort provoked by mental, physical, or emotional stress. Discomfort can vary widely among patients who report shortness of breath, fatigue, indigestion, faintness, jaw pain, and other symptoms. Angina can also feel like a pressing or squeezing pain, usually in the chest under the breast bone, and sometimes in the shoulders, arms, neck, jaws, or back.

How does Angina affect people ?
Angina restricts the activities of many patients. They are able to walk, but not uphill or carrying packages. For some patients, angina is disabling, interfering with their ability to work or engage in various activities.

How is Angina avoided ?
Doctors recommend controlling the risk factors that contribute to underlying coronary artery disease. These risk factors include high blood pressure, cigarette smoking, high blood cholesterol levels, and obesity. Doctors recommend controlling the risk factors that contribute to underlying coronary artery disease. These risk factors include high blood pressure, cigarette smoking, high blood cholesterol levels, and obesity.

What is the first line of treatment for Angina ?
Angina is usually controlled by medication that helps increase the supply of oxygen to the oxygen-deprived heart muscle by dilating coronary vessels or decreasing the demand for oxygen. Unfortunately, in most patients, medication becomes less effective over time. Angina is usually controlled by medication that helps increase the supply of oxygen to the oxygen-deprived heart muscle by dilating coronary vessels or decreasing the demand for oxygen. Unfortunately, in most patients, medication becomes less effective over time.

When should ECP treatment be used for Angina ?
ECP treatment may be used to treat any patient with chronic stable angina, but it is usually reserved for patients taking medication that is losing its effectiveness.

What is ECP treatment ?
The ECP procedure is a noninvasive outpatient treatment that is used to relieve or eliminate angina. It is believed to create new pathways around blocked arteries in the heart by expanding networks of tiny blood vessels that help increase blood flow to the heart muscle.

What are the advantages of ECP treatment ?
Unlike procedures such as bypass surgery and balloon angioplasty, ECP® treatment can be administered in outpatient sessions, carries little or no risk, and is relatively comfortable.

Will ECP treatment eliminate the need of bypass surgery ?
No. Some patients with more extensive disease or those who have disease of the left main coronary artery require bypass surgery. ECP treatment is an option for patients who are unsuitable for or unwilling to undergo, invasive procedures. For patients who have undergone multiple invasive procedures and for whom additional surgery carries excessive risk, ECP treatment may be the only way to obtain relief from crippling angina.