Enhanced external counter-pulsation (EECP) therapy is being used in several places in India as a treatment for coronary artery disease. In fact, some of these centers, advertise EECP as an alternative to angioplasty or bypass surgery. This is also being advertised in such a way that this therapy has been approved by US Food and Drug administration (FDA). It is crucial for patients and families to understand the FDA approval for EECP. Yes, the FDA has approved EECP treatment. But the document from FDA very clearly states the section of patients who should be offered this therapy. It is only approved for the following group of patients:
“FDA approval is provided for the use of EECP for patients who have been diagnosed with disabling angina (New York Heart Association Class III or IV, or equivalent classification) who, in the opinion of a cardiologist or cardiothoracic surgeon, are refractory to maximum medical therapy and are not readily amenable to surgical intervention, such as PTCA or cardiac bypass because: Their condition is inoperable, or at high risk of operative complications or post-operative failure; or their coronary anatomy is not readily amenable to such procedures.”
In simple terms, the above paragraph says that EECP can be considered for patients who cannot undergo angioplasty or surgery and still have symptoms despite optimal medical therapy (refractory angina). So, EECP never should be considered an alternative therapy to angioplasty or bypass surgery- as advertised by some centers in India.
More importantly this therapy is not approved, to be used in the National Health Service (NHS) in United Kingdom after thorough analysis by the National Institute for Health and Care Excellence (NICE). It was decided that there is not much clinical evidence available for the use of EECP in patients with angina. Click below to read about the NHS statement-
http://www.nhs.uk/Conditions/Angina/Pages/Treatment.aspx
(scroll down on the above page to subheading “If treatment is ineffective”)
It must be also noted that the benefit, if anything, due to EECP is achievable only after one-hour sessions, five days a week, for seven weeks.
