What Is EECP / ECP Treatment / What Is EECP / ECP Therapy?
EECP / ECP is a non-invasive treatment for coronary artery disease. EECP / ECP is the first non-surgical, non-pharmaceutical or mechanical treatment approved by the US FDA for patients with chest pain, heart failure and congestive heart failure. EECP / ECP essentially is a heart therapy without the side-effects of heart surgery. What ECP / EECP therapy does is it helps to increase blood supply throughout the body, with benefits that tend to remain for years together. EECP / ECP therapy works by creating collateral circulation around blocked arteries, i.e. it essentially works to create a “natural bypass” around the arteries.
What Do EECP / ECP Sessions Involve?
In an EECP / ECP session, the patient lies on a padded table. Three large inflatable cuffs – similar to blood pressure cuffs – are strapped around the calves, lower-thighs and upper-thighs. The patient's heart is monitored by an electrocardiograph display in the EECP / ECP machine, which through the computer, regulates the inflation and deflation of the cuffs. During the part of the cardiac cycle when the heart is as rest (diastole), the cuffs are rapidly inflated in sequential order beginning with the cuffs on the calves and working upward. Just before systole (heart contraction), the cuffs are simultaneously deflated.
EECP / ECP generally involves 35 sessions of treatment. Each session is for 1 hour and the patient is usually asked to come 6 days a week, for 6 weeks. However, the entire team at IPC is very well trained on how to make adjustments in the protocol, where needed, to treat difficult cases. So EECP / ECP at IPC is very safe and applicable to even most of the cases that cannot be handled by other EECP centres. IPC makes every effort to see to the comfort of the patient and his / her body.
How Does EECP / ECP Work?
In a nutshell, EECP / ECP causes immediate and sustained increase in the heart’s blood supply by:
- Dilating coronary blood vessels
- Opening dormant collaterals
- Creating new blood vessels (angiogenesis)
ECP / EECP treatment helps form a network of tiny blood vessels that make it possible for blood to detour around blocked or narrowed arteries. This is referred to as "collateral circulation”. Collateral circulation is actually a natural phenomenon that can be developed with cardiovascular exercise also. However, the natural development of collateral circulation is a gradual process that takes years. EECP / ECP treatment triggers and accelerates this collateral circulation and makes it permanent. In fact, it is found that 35 sittings of EECP / ECP have the same effect as athletic training for 5 years! Still, we at IPC would only like to hook you up to a machine if you absolutely need it. So, do not underestimate the power of regular exercise.
Because of increased blood flow and pressure during EECP / ECP there is high pressure exerted on the open coronary arteries and lower pressure in closed arteries. So, the blood finds its way to the low pressure zone or area, which has the decreased blood supply, by opening the collaterals. These collaterals eventually become permanent.
EECP / ECP also tends to improve your endothelial cell function (the cells that line your coronary arteries), which determine your chance of getting heart attacks.
EECP / ECP increases blood-flow to the muscles of the heart that are not receiving enough blood supply. EECP / ECP thus works to create a “natural bypass”.
Please note that while EECP / ECP increases blood supply to the heart muscles by developing collateral circulation, it does not remove blockages. This is much like bypass surgery, which is a mechanical treatment that circumvents the blocks by stitching the grafts, but does not remove the blocks.
Is EECP Heart Treatment Different from ECP Heart Treatment?
EECP stands for Enhanced External Counter-Pulsation. EECP is indeed different from ECP (External Counter Pulsation), in that ECP lacks the graduated timing mechanism, which determines the cuff inflation and deflation, and the unique cuff design of the EECP machine — both specially designed to maximize augmentation — which is a very important part of the treatment. EECP is a registered trademark of Vasomedical, Inc., the leading manufacturer of EECP / ECP equipment in the U.S.
IPC (Institute of Preventive Cardiology) Heart Care’s EECP / ECP equipment is imported from Vaso Meditech, USA, and IPC works in technical collaboration with the company.
What Are the Benefits of EECP / ECP Treatment?
Besides improving collateral circulation and creating a natural bypass, the International Registry of EECP / ECP Patients has data to support the following benefits of ECP/EECP treatment:
- Decreased episodes of Angina
- Decreased use of Nitroglycerine
- 85% increase in angina classification, by class 1
- 55% increase in angina classification, by class 2
- Improvement in Exercise Time
- Improvement in overall quality of life, mood and feeling of well-being
Positive Vascular benefits – Increase in ANG II, NO, ANP, BNP, Ejection Fraction, and Cardiac Output; Lowering of Heart Rate; Decrease in Endothelin (protein that constricts blood vessels).
Stress Thallium scans show an improvement in blood supply. Other benefits of EECP / ECP include, a lowering of serum cholesterol levels, lowering of serum blood sugar levels, lowering of blood pressure in hypertensive patients, etc.
A study of 5022 patients in 92 centers, conducted by the International Registry of EECP / ECP Patients showed 5 year survival rates of:
- 88% for EECP / ECP Patients
- 78% for Patients on Heart Medication only
- 86-89% for Patients of Bypass or Angioplasty
We would like you to apply your minds to these figures to realize how IPC’s Cardiac Rehabilitation Program which combines medication, exercise, diet, yoga, and even Arterial Clearance Therapy (Chelation therapy) or EECP / ECP therapy, if needed, can benefit you.
Why IPC for EECP / ECP Treatment?
IPC’s Chairperson Dr. Pratiksha was the first to introduce EECP / ECP therapy in Maharshtra in 2004.
IPC is India’s largest provider of EECP / ECP. IPC Heart Care Center has carried out EECP / ECP on more than 10000 cases and has treated the largest number of primary cases in the world.
EECP/ECP therapy has an 85% success rate the world over, IPC has a 95% success rate. Contributing to this augmented success is its unique cardiac rehabilitation program, administered for every patient along with EECP therapy.
Dr Pratiksha has been instrumental in setting up the Indian EECP / ECP Patients Registry, and represents Western and Eastern India in the Expert EECP / ECP Committee. The Indian Registry makes it mandatory for all data of ECP / EECP patients to be registered with them.
IPC registers every patient of EECP / ECP with the International Registry too. This means that all the medical details, treatment and progress of every patient is monitored by the top doctors around the globe. IPC follows strict international guidelines.
IPC Heart Care has a unique on-line monitoring system through which every patient’s readings can be monitored by Dr Pratiksha and her team of doctors from anywhere, even while an EECP / ECP session is in progress.
IPC pairs ECP / EECP treatment with its holistic Cardiac Rehabilitation Program. If medical tests are normal, other treatments like ACT (Arterial Clearance Therapy) can also be given along with EECP/ECP. It does not just offer EECP / ECP like other EECP / ECP treatment centers in India might, but offers a comprehensive cardiac rehabilitation program that is tailored for each patient. This includes yoga and meditation, nutritional counseling and diet planning, stress counseling, etc.
IPC carries out intensive screening for patient selection. There are some patients who cannot be administered EECP / ECP (e.g. for leaks from valves, etc) and there are some for whom it is not indicated – IPC does not undertake EECP / ECP for such patients. IPC’s EECP / ECP patients generally include: Those who do not want to do bypass surgery; Those who cannot afford bypass surgery; Those who are not operable because they are very weak or are high-risk because of complications; Those who have already undergone a bypass, have not benefitted, and are looking for an alternative to bypass surgery.
IPC Heart Care Center’s equipment is all clinically proven, evidence-based therapeutic systems, documenting the effectiveness and safety of ECP / EECP® in the treatment of patients with coronary heart disease with:
- More than 150 published papers in world renounced medical journals
- 4 randomized, controlled prospective studies for the treatment of patients with angina pectoris and heart failure
- 2 International patient registries of more than 8,000 patients monitoring clinical outcomes and adverse events
- Clinical studies demonstrating the long-term effects with up to 5-year follow-up
- Numerous studies investigating the mechanisms of action of EECP / ECP ® treatment
How Many EECP / ECP Center Are There in India?
There are almost 70 ECP centers in India today. IPC was the first EECP center to be set up in Maharashtra, about 6 years ago. IPC has more ECP / EECP clinics in India than any other center. Some major hospitals have only recently started offering EECP treatment. However, IPC Heart Care handles the largest number of cases every year, and has handled more cases than any other center in the country. With a success rate of 95%, you can be sure that IPC’s efficient staff is geared up to offer you quality treatment.
IPC’s EECP/ECP Centers In India / IPC’s EECP / ECP Locations
IPC has 4 branches with EECP / ECP centers in Mumbai. The locations for EECP / ECP and other therapies in Mumbai include Lower Parel, Borivali, Thane and Andheri. We have a branch in Lonavala, and are in plans for establishing branches elsewhere too.
Who Can Benefit from EECP / ECP Treatment?
- People with chronic angina pectoris (chest pain)
- Patients with heart failure and congestive heart failure
- Patients who have suffered myocardial infarction (Heart Attack) or cardiogenic shock
- Patients of atherosclerosis (plaque in arteries / blocked arteries)
- Patients who are not operable because they are too weak or have too many complications to undergo bypass surgery or angioplasty, and are looking for an alternative to heart surgery
- Patients who cannot afford bypass surgery or angioplasty
- Patients who are looking for a natural alternative to bypass surgery or an alternative to angioplasty because they have already undergone these surgeries in the past and their conditions have recurred
EECP/ECP is also helpful in patients of:
- Diabetic patients with poor blood circulation
- Renal Hypertension
- Cerebral arteriosclerosis / Thrombosis / embolism
- Chronic Fatigue (tiredness) syndrome
Is the Cost of EECP / ECP Covered By Medical Insurance?
Although the cost of EECP / ECP is covered by medical insurance in the US, UK and quite a few more countries, it is not covered in India. Even so, when compared with the cost of heart surgeries, the cost of ECP / EECP treatment is quite affordable. However, we implore people to put concerns for payments aside and seek the treatment that is right for them. There are many benevolent donors who we can approach in order to try to subsidize the cost of your EECP / ECP treatment, and have even given subsidized EECP / ECP treatment to many in the past..
Please do contact us if you wish to be a donor for someone’s EECP / ECP treatment. We will be extremely grateful.
Preparations Before the Treatment
EECP / ECP is a safe, out-patient, non-invasive treatment. So you do not have to restrict any of your daily activities. You can schedule the time for your 1-hour treatment according to your convenience. Before you start the treatment, our doctors will give you instructions.
Besides instructions that may be particular to you case, you will be asked to follow these general instructions:
- Wear tight-fitting elastic pants. This is to prevent skin irritation or abrasion.
- Avoid ingesting food for 2 hours before the treatment
- Empty your urinary bladder before starting the session.
- If you are taking any diuretic medication, avoid taking it before the treatment.
- Continue your regular medication as prescribed by your physician.
Advantages of EECP / ECP over Surgery:
- Non-invasive therapy
- Carried out on out-patient basis – no need for hospitalization
- Low risks
- No additional medication required
- No recuperation time
- No side-effects
- Patients have reported increased exercise tolerance, energy and freedom from chest pain following EECP / ECP treatment
- No risks of surgery
IPC Heart Care’s EECP / ECP Technology Approvals include:
FDA Approval for use in treatment of patients with congestive heart failure, stable angina pectoris, acute myocardial infarction, cardiogenic shock
- CE MARK approved
- ELT listed
- ISO 9001 certified
Dr Elmer M. Cranton, M.D., is a global authority on Chelation Therapy and preventive cardiology. His book ‘Bypassing Bypass Surgery’ has sold over 2,00,000 copies worldwide. IPC Heart Care Foundation was generously given sole rights to reprint the book in India, and IPC’s Founder and Chairperson, Dr Pratiksha has jointly written the version of ‘Bypassing Bypass Surgery’ distributed in India, with Dr Cranton.
Do visit Dr Cranton’s website: www.drcranton.com