Non-surgical Bypass Treatment in Heart Attack Patients – EECP
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Non-surgical Bypass Treatment in Heart Attack Patients – EECP

Coronary Artery Disease (CAD) is a narrowing or blockage of the vessels (coronary arteries) that provide oxygen and nutrients to the heart. It is caused by accumulation of fatty materials (atherosclerosis) on the inner linings (endothelium) of coronary arteries.
In India, the incidence of CAD (Heart attack) patients is steadily increasing due to moderanisation of life style. Approximately 16% of total wolrd-wide deaths due to heart attack occur in India
The heart attack patients need emergency medical care and investigations, and after confirming the diagnosis, physicians advise medical treatment, angioplasty-stent and / or bypass surgery, which have their own limitations. During & after these surgical interventions, many patients encounter various complications including blockages of stents & bypass grafts within 5-10 years. Furthermore, these invasive treatments target only the obstructive lesions, but the disease & its cause are still present after treatment because Coronary Artery Disease is a progressive disease.
Enhanced External Counter Pulsation (EECP) therapy with its different mode of action like progressive angiogenesis leading to development of collaterals, improvement in endothelial function, anti-inflammatory effect and release of vasodilator peptides, provides a new treatment modality in the management of CAD and complements the invasive revascularization. It is a non-invasive, outpatient therapy consisting of electrocardiography (ECG) – gated sequential leg→thigh→buttock compressions which produces hemodynamic effects similar to those of an intra-aortic balloon pump (IABP).
EECP has been approved by US-FDA (USA), NHS (UK), CE-mark certification (Europe), American Heart Association (AHA) and American Collage of Cardiology Foundation (ACCF) for the treatment of Ischemic Heart Disease and Heart Failure.

EECP Procedure:
EECP therapy consists of a treatment bed attached to an air compressor unit which is attached to a computerized control console. Three sets of cuffs wrapped around the lower legs, thighs & buttocks of the patient which inflate rapidly and sequentially at an interval of 0.4 seconds starting from the calves→thighs→buttocks during the relaxation phase of heart beat (Diastole). This creats a strong retrograde counterpulse (Pressure as high as 220-300 mm Hg) in the arterial system, forcing freshly oxygenated blood to the coronary arteries and in the venous system, increasing the venous blood return.

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Coronary Artery Disease (CAD) is a narrowing or blockage of the vessels (coronary arteries) that provide oxygen and nutrients to the heart. It is caused by accumulation of fatty materials (atherosclerosis) on the inner linings (endothelium) of coronary arteries.
In India, the incidence of CAD (Heart attack) patients is steadily increasing due to moderanisation of life style. Approximately 16% of total wolrd-wide deaths due to heart attack occur in India
The heart attack patients need emergency medical care and investigations, and after confirming the diagnosis, physicians advise medical treatment, angioplasty-stent and / or bypass surgery, which have their own limitations. During & after these surgical interventions, many patients encounter various complications including blockages of stents & bypass grafts within 5-10 years. Furthermore, these invasive treatments target only the obstructive lesions, but the disease & its cause are still present after treatment because Coronary Artery Disease is a progressive disease.
Enhanced External Counter Pulsation (EECP) therapy with its different mode of action like progressive angiogenesis leading to development of collaterals, improvement in endothelial function, anti-inflammatory effect and release of vasodilator peptides, provides a new treatment modality in the management of CAD and complements the invasive revascularization. It is a non-invasive, outpatient therapy consisting of electrocardiography (ECG) – gated sequential leg→thigh→buttock compressions which produces hemodynamic effects similar to those of an intra-aortic balloon pump (IABP).
EECP has been approved by US-FDA (USA), NHS (UK), CE-mark certification (Europe), American Heart Association (AHA) and American Collage of Cardiology Foundation (ACCF) for the treatment of Ischemic Heart Disease and Heart Failure.

EECP Procedure:
EECP therapy consists of a treatment bed attached to an air compressor unit which is attached to a computerized control console. Three sets of cuffs wrapped around the lower legs, thighs & buttocks of the patient which inflate rapidly and sequentially at an interval of 0.4 seconds starting from the calves→thighs→buttocks during the relaxation phase of heart beat (Diastole). This creats a strong retrograde counterpulse (Pressure as high as 220-300 mm Hg) in the arterial system, forcing freshly oxygenated blood to the coronary arteries and in the venous system, increasing the venous blood return. Just before the next heart-beat (Systole), all three cuffs deflate simultaneously, reducing the heart’s after-workload by significantly lowered resistance to blood ejected by the heart in the relatively empty vascular beds in the lower extremities.

EECP therapy course generally consists of 35 sittings administered 1 hour a day over 5-7 weeks.

EECP Indications:
EECP is a non-invasive & outpatient therapy, beneficial in relieving Angina pain in almost 80% patients not responding to maximal medical treatment and is advised in :-

  1. Patients who have previous invasive revascularization treatment like Angioplasty-Stent & / or Bypass surgery being failed due to stenosis of stents or blockage in bypass grafts.
  2. Patients who are not fit for invasive / surgical procedures because of unsuitable coronary anatomical effects like diffuse coronary sclerosis.
  3. Patients who are not fit for Angioplasty-Stent & / or Bypass surgery because of associated advanced extra-cardiac diseases like Renal failure, Hepatic failure or Pulmonary failure.
  4. Patients who are not willing for any surgical intervention because of their own wish or financial constraints.

EECP Advantage:
The benefits of EECP therapy are documented by:-
A.    Improvement in Symptoms: During EECP treatment, patient is asked for symptoms relief predicting:-

  • Decrease in episodes & intensity of anginal pain
  • Increase in work capacity in walking, climbing upstairs
  • Betterment in overall wellbeing & sleep pattern
  • B.    Improvement in Stress Thallium/ CTMT/ Echocardiography: Patient undergoes thes tests pre- & post-EECP treatment predicting:-

  • Increase in Myocardial perfusion
  • Increase in Exercise duration (METS)
  • Increase in Ejection Fraction (EF)
  • EECP in Extra-cardiac Diseases:
    EECP increases blood supply to all vital organs like Heart (20-42%), Brain (22-26%) & Kidneys (19-20%), that’s why it is not only effective in heart attack but also beneficial in palalysis (Ischemic Stroke), Dementia (multi-infarct), Parkinson’s disease and vascular renal diseases.

    EECP in Prevention of Heart Attack:
    EECP therapy is advised before bypass surgery to improve the myocardial function so as to decrease operative & post-operative complications, morbidity and mortality. On the other hand, it is also advised in post-angioplasty & post-CABG patients so as to avoid early stenosis of stents and blockages in bypass grafts.
    The chances of heart attack increases by many folds in persons carrying two or more  risk factors like Diabetes, Hypertension, Dyslipidemia, Obesity, Tobacco users or Stress. Preventive EECP therapy in this population can minimize the incidenc & intensity of heart attacks.
    After getting popularity in USA, UK & European countries, EECP therapy is now being done successfully in reputed hospitals all over India.

    DR.ASHOK GOYAL, MD
    Bani Park Heart, EECP & General Hospital
    D-9, Kabir Marg, Bani Park, Jaipur – 302016
    Phone: 0141-22038640141-2203864/66, Mobile: 9314502380; Email: This email address is being protected from spambots. You need JavaScript enabled to view it.; Website: www.bphospital.net

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    Comments

    0 # Priyansh 2018-06-02
    Hello, I am from Muthuramalingam, PLz suggest some biochemic remedies for gonorrhoea .
    Reply | Reply with quote | Quote
    0 # Dr. Pooja 2018-06-03
    Kali Mur, Natrum Mur, Natrum Sulph, and silicea are few important biochemic emedies in homoeopathy which can be used safely in this case, you can also take advise from gynecologist given here-Gynecologist in Muthuramalingam.
    Reply | Reply with quote | Quote
    0 # Aayush 2018-06-02
    Hii, I am from Srikakulam, I want to know can cigerrete sharing can lead to syphilis ?
    Reply | Reply with quote | Quote
    0 # Dr. Naresh 2018-06-03
    yes,sharing cigerette,drinking cups,common spoons etc can also lead to syphilis, Generally whenever the fluid of a person who has syphilis is shared,the infection can occur, you should also consult with good Gynecologist in Srikakulam
    Reply | Reply with quote | Quote
    0 # Aayush 2018-05-26
    Hii, plz tell me,Which tests can confirm syphilis in primary stage, also suggest name of good maternity hospitals in Jalgaon ?
    Reply | Reply with quote | Quote
    0 # Dr. Pooja 2018-05-27
    During the primary stage,DG illumination tests are very helpful, find good maternity hospitals-Siddhivinayak Hospital ; Asha Maternity and Children Hospital ; Shree Surgical Maternity Home ; Shri Surgical and Maternity Home.
    Reply | Reply with quote | Quote
    0 # Rohan 2018-05-05
    Hii can you plz tell me, Which fluids can cause or spread syphilis infection, alos give me the list of good gynec in Khammam?
    Reply | Reply with quote | Quote
    0 # Dr. Naresh 2018-05-06
    Infection from semen, blood or lactation milk can occur and cause syphilis, Infection from blood syringes is very common, Infected mothers can transmit it through their milk also, consult with good Gynecologist in Khammam .
    Reply | Reply with quote | Quote
    0 # Aarush 2018-04-21
    Hello, plz let me know What is menarche, I want to consult with gynec in Chandauli, plz suggest ?
    Reply | Reply with quote | Quote
    0 # Dr. Pooja 2018-04-22
    the process of starting of the menstrual cycle in females is called menarche, plz find good Gynecologist in Chandauli.
    Reply | Reply with quote | Quote
    0 # Tushar Older than three months
    Hello, plz let me know Can gonorrhoea be transmitted to small children, should I consult with good maternity doctor in Khargone
    Reply | Reply with quote | Quote
    0 # Dr. Pooja Older than three months
    yes,this can be transmitted by infected mothers to children, In this case it is called as ophthalmia neonatorum, find list of good doctor-.Obstetrician in Khargone
    Reply | Reply with quote | Quote
    0 # Aarush Older than three months
    Hi, plz let me know What is the incubation period of Syphilis, also give me the list of good female's specialist in North West Delhi ?
    Reply | Reply with quote | Quote
    0 # Dr. Pooja Older than three months
    Hii, The incubation period can be 10 to 90 days, plz find list of Gynecologist in North West Delhi
    Reply | Reply with quote | Quote
    0 # Jayesh Older than three months
    Hello I am from Ratnagiri, My neighbour has been feeling redness and burning in urethral organs, can it be a disease, should she visit gynec?
    Reply | Reply with quote | Quote
    0 # Dr. Pooja Older than three months
    It can be a simple infection also and a disease also, If after the examination, the presence of gram negative bacteria is seen ,gonorrhoea infection can be thought of, she should visit good women's specialist- find list of Gynecologist in Ratnagiri
    Reply | Reply with quote | Quote
    0 # Aarav Older than three months
    Hello, I am from West Tripura, PLz suggest some biochemic remedies for gonorrhoea .
    Reply | Reply with quote | Quote
    0 # Dr. Pooja Older than three months
    Kali Mur, Natrum Mur, Natrum Sulph, and silicea are few important biochemic emedies in homoeopathy which can be used safely in this case, you can also take advise from gynecologist given here-Gynecologist in West Tripura.
    Reply | Reply with quote | Quote
    0 # Priyansh Older than three months
    Hii, I am from Kamrup, can you plz tell me What is the mode of infection in syphilis ?
    Reply | Reply with quote | Quote
    0 # Dr. Naresh Older than three months
    90 percent cases in syphilis are transmitted through unsafe sexual contacts, Mothers can also pass infection through breast milk, you can also consult with good Gynecologist in Kamrup .
    Reply | Reply with quote | Quote