Enhanced External Counterpulsation

What Is Enhanced External Counterpulsation?

Enhanced external counterpulsation (EECP) can stimulate the openings or formations of small branches of blood vessels to create a natural bypass around narrowed or blocked arteries.

Who Is a Candidate for EECP?

EECP may be a suitable treatment for patients who have persistent anginal symptoms, have exhausted the standard treatments for revascularization, and remain severely restricted.

You may be a candidate if you:

  • Have chronic stable angina
  • Are not receiving adequate relief from angina by taking nitrates
  • Do not qualify as a candidate for invasive procedures


EECP gently but firmly compresses blood vessels in the lower limbs in order to increase blood flow to your heart. As each wave of pressure is electronically timed to the heartbeat, the increased blood flow is delivered to your heart at the precise moment it is relaxing. The next time the heart pumps, pressure is released instantaneously, lowering resistance in the blood vessels in the legs so that blood may be pumped out more easily from your heart.

The procedure is designed to encourage blood vessels to open small channels that become extra branches, providing a means for these channels to eventually become natural bypass blood vessels that will provide adequate blood flow to the heart muscle.

The goal is the relief of angina symptoms.


What Happens During EECP?

Patients will receive the treatment while lying down on a table. Electrodes will be attached to your heart, which lead to an electrocardiograph (ECG) machine.

The ECG will monitor the heart’s rhythm as well as blood pressure during treatment. Additionally, you will have a set of cuffs around your calves, thighs, and buttocks, which will be attached to air hoses that use valves to inflate and deflate the cuffs.

While this is happening, you may feel light sensations during inflation and then a rapid release of pressure on deflation.