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Enhanced external counterpulsation (EECP) is a relatively new and painless treatment for angina and heart failure. The goal of the procedure is to increase oxygen-rich blood flow to the heart and to reduce the heart’s workload. EECP is performed over a series of several weeks, with each session lasting from one to two hours. The procedure has so far been performed in more than 5,000 patients with generally good results. It is usually recommended for patients who are not suitable for other procedures, such as coronary artery bypass graft surgery or a catheter-based procedure.

During each session, air (pneumatic) cuffs are placed on each of the patient’s calves, lower thighs and upper thighs. Precisely timed by a computer to match the heartbeat, these cuffs are rapidly and sequentially inflated from the calves to the upper thighs. As a result, the blood vessels in the leg are gently compressed and blood is forced back to the heart.

This may reduce the pain of angina, increase one’s capacity for exercise and decrease the need for medication. Unfortunately, some patients (e.g., those with pacemakers) may not be appropriate for EECP.