When the first two become ineffective, the only option available is to go in for invasive treatments like angioplasty or bypass surgery.
They are frequently ineffective and are invariably associated with numerous side effects and complications in addition to being expensive. Heart surgery carries a significant risk of death and often leads to other morbid events. Further, a significant number of 'successfully treated' patients become 'treatment failures' over a period time; only three out of four remain free of cardiac ischemia for five years and this figure drops to two in ten years!
Hence there is dire need for alternate modes of therapy that is safe, noninvasive and also cost effective. There currently is such a therapy which is an entirely new method of treatment for heart diseases. This procedure is called External Counter-pulsation (ECP) or Enhanced External Counter-pulsation (EECP).
Dr Abdul Kalam, in his address at the Second World Congress on Interventional Cardiology at Mumbai on 25.2.2005, made fervent plea for introducing totally noninvasive means to treat cardiac ailments. He said: "External Counter Pulsation (ECP), a truly non-operative, non-pharmaceutical, safe and effective treatment which has made big news in the west. ECP is FDA (USA) approved and finds reference in medical and cardiology textbooks... Now the treatment is available in most of the leading hospitals of the world."
What is ECP?
Developed over a period of nearly 50 years, External counter-pulsation (ECP), also named Enhanced External Counter-pulsation (EECP) is an ingenious method of treating Angina without use of drugs and is completely non-invasive. Though the concept of 'diastolic augmentation' was described by Kantowitz in the year 1950 itself and ten years later Birtwell and Clause working at Harvard, using the same principle, developed the Intra-aortic Balloon Pump to help blood circulation during cardiac surgery, it was only in 1983 that Zheng and associates at Sun Yat Sen University in China designed the first pneumatic external counter-pulsation system. It produced excellent results to alleviate coronary insufficiency and long-term relief from chronic angina.
An ECP unit consists of a computer which triggers the sequential inflation with compressed air cuffs that are wrapped around a patient's calves, thigh and buttocks.
As the cuffs are inflated blood is pushed from the lower part of the body back into the heart. At the end of diastole, the ECP computer signals the sudden and simultaneous deflation of the cuffs, greatly reducing vascular resistance and assisting the heart with its next beat. This action also facilitates return of blood into the heart from the veins and thereby increasing cardiac output.
Most researchers are of the opinion that ECP helps angina by releasing of a hormone known as Vascular Endothelial Growth Factor (VEGF) which promotes development of collateral coronary vessels. In other words, ECP helps the heart to grow its own bypasses.
