A Noninvasive Therapy For Patients Suffering From Angina Pectoris

Your heart is the pump that supplies blood flow throughout the entire body. It supplies tissues with the oxygen and nutrients that are needed to sustain life. In order to efficiently accomplish this task, the heart muscle needs oxygen-enriched blood to generate energy for pumping blood to the body. Since the heart cannot obtain oxygen directly from the blood in the heart's chambers, it relies on its own set of blood vessels called coronary arteries.

The coronaries are different from other arteries in that the maximum blood flow through them occurs during diastole (when the heart is resting between heartbeats). Other arteries receive their blood supply during systole (when the heart is pumping). The coronaries cannot receive blood when the heart is pumping because they are constricted from the contraction of the heart muscle. In many people, the coronary arteries become narrowed or obstructed. During exercise or stressful situations, an insufficient amount of blood is delivered to parts of the heart muscle. The result is often a painful experience called angina pectoris. The external counterpulsation system is a noninvasive device that may increase blood flow to the heart, thereby reducing the symptoms of angina pectoris.

What is external counterpulsation?

It is a noninvasive procedure that may reduce the symptoms of chronic angina. While the exact mechanism that allows external counterpulsation to reduce angina symptoms is not known, it is presumed that the increase in coronary blood flow to the heart during this therapy is why the symptoms are reduced or eliminated. The beneficial effects appear to be sustained between treatments, and have persisted in some patients for a number of years.

How does the external counterpulsation system work?

When being treated with the counterpulsation system, you lie comfortably on a bed. A series of cuffs (like large blood pressure cuffs) will be placed on your calves, thighs and around your buttocks. The system will inflate and deflate these cuffs, moving the blood from your lower limbs toward your heart. The system times the inflation and deflation of the cuffs to your heart beat from your electrocardiogram signal. The timing is such that your heart receives the increased blood flow precisely when it is relaxing and the flow through your coronary arteries is at its peak. A fraction of a second before your heart beats again, the cuffs are instantaneously deflated, enabling the blood in your heart to be pumped with minimal resistance into empty blood vessels. Since the system is timed to your heartbeat, it will automatically turn off if your heartbeat goes below or above a specific rate.

Is external counterpulsation painful?

External counterpulsation therapy feels like a vigorous massage. Many patients actually find they are able to read, watch videos, listen to music or just relax during therapy. Since chafing can occur from the slight movement of the cuffs during inflation/deflation, Spandex "tights" should be worn during treatment.

What is the standard treatment and how long does therapy take?

Therapy requires 35 one-hour sessions, that are provided 5 days per week, during the course of a seven week period.

How long before I feel improvement?

There is no certain treatment time after which you might feel better. Generally, as the number of hours of treatment increases, improvement is observed.

What benefits may this treatment provide?

External counterpulsation may have a number of benefits, depending on your individual condition. Patients suffering from chronic angina have experienced relief from the pain associated with this condition, along with increased exercise ability and reduced need for medications.

Potential clinical benefits may include:

Relief from anginal symptoms.
Improved treadmill exercise times.
Reduction in the need for antianginal medications.
Improved activity levels.

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