Consider ECP therapy for coronary artery disease

External counter Pulsation (ECP) therapy, a unique opportunity to save countless lives and billions of dollars, is being  overlooked by the medical community.

This technique increases blood flow to the heart, strengthens the circulation, and offers a proven way to treat heart disease in lieu of stents or bypass surgery.

This technique has been FDA approved since 1987 for 1. Stable Angina Pectoris 2. Unstable Angina Pectoris 3. Acute Myocardial Infarction 4. Cardiogenic Shock. 5. Congestive heart failure.

In Malaysia, the ECP medical device has been used in our medical centre since 2002.

External counterpulsation (ECP) is a safe, non-invasive procedure that can overcome heart disease in two ways-by passively exercising the heart to strengthen the vascular system and by targeting inflammation, the underlying culprit in damaged blood vessels that inhibits blood flow.

More than 100 studies have demonstrated its overwhelming effectiveness and unquestioned safety in improving blood flow in patients with heart disease.

Some experts are calling for the ECP procedure to become first-line therapy for heart disease, long before surgery or other invasive procedures are used.

Approved by the FDA for chronic stable angina, cardiogenic shock, congestive heart failure, as well as during a heart attack, ECP not only saves lives but is also considerably cheaper and safer than traditional invasive procedures such as angioplasty and coronary stents, which continue to be the mainstay of therapy which requires repeated procedures. Insurance even pays for it.

ECP By improving circulation, this simple procedure prevents arteries from becoming blocked, allowing the heart to do its job more effectively.

As is often the case, health care in the United States and elsewhere is often driven by lucrative revenues making many in the medical community reluctant to embrace alternative therapies.

We have first enlightened our members to the benefits of ECP therapy in May 2002, yet most foundation members still don't realise this life-saving technology is available.

In this article, we'll review why we should no longer afford to ignore the benefits of this inexpensive, life-saving procedure.

Good news is our new DG Health of Malaysia has been calling for reformation of healthcare system soon. Insurance policies should also be reformed.

There are now about 15 medical centres and hospitals providing ECP therapy in Malaysia.

In our 11 years experience in treating thousands of patients with ECP therapy it was found to be at least 85% successful, for patients with some forms of heart disease.

External counterpulsation (ECP) is a non-invasive, high-tech, low-risk procedure, performed on an outpatient basis, which offers a remarkable reprieve from some of the potentially disabling symptoms of stable angina and coronary heart disease.

Patients lucky enough to be offered this underused therapy may experience changes in their conditions that range from significant pain relief to renewed mobility and energy, to a rekindled libido.

They may also literally gain a new lease on life, simultaneously avoiding the dangers of coronary bypass surgery. But chances are, unless you inquire about it, you'll never even be told this option exists.

Therefore we need to make awareness among public and doctors.

Imagine this scenario. You've developed troubling symptoms recently-shortness of breath, difficulty climbing stairs without resting frequently, and maybe even some pressure or pain in your chest.

If you're a man, you may have noticed a decrease in libido, or an occasional inability to sustain erection during sex. You may even break out into a sweat inexplicably from time to time.

Such patients should ask for ECP therapy as a first line of therapy.

I would also like to share our experience in using external counterpulsation (ECP) for the treatment of Cardiac Syndrome X.

ECP has been shown to be an effective treatment for refractory angina in end stage coronary disease patients, improving both subjective and objective measures of ischemia and associated functional impairment.

ECP increases coronary blood flow and velocity and has been shown to increase nitric oxide and cGMP, decrease endothelin and angiotensin II levels, mobilize endothelial progenitor cells and inhibit intimal hyperplasia. ECP has also been demonstrated to promote collaterals, coronary vasodilation, and decrease vascular disease progression.

ECP therapy increases shear stress and could be expected to improve the endothelial dysfunction associated with Syndrome X.

It is amazing that elderly patients above 90 years old enjoys ECP therapy with some physical and mental improvement.

Patients without significant angiographic epicardial coronary artery disease can suffer chronic disability from microvascular angina (cardiac Syndrome X) which is unresponsive to usual antianginal medical therapy.

Microvascular coagulation and flow rate can be demonstrated by means of latest Video microscope at the junction of skin and finger nails on the doctor's office table within two minutes.

(Ref: International Journal of cardiology , 1 March, 2008.)

What you need to know about ECP therapy

i. Stable coronary artery disease and angina can cause disabling symptoms including shortness of breath, pressure or discomfort in the chest, exercise intolerance, and fatigue.

ii. Physicians commonly treat coronary artery disease and angina using invasive procedures such as angioplasty/stents and coronary artery bypass grafting. While such treatment temporarily restores blood flow to the heart, but it will not last for long, reclosing of the arteries is common.

iii. ECP ,a safe, effective, non-invasive therapy for the symptoms of coronary artery disease and angina is now available.

iv.External counterpulsation (ECP) alleviates cardiac symptoms by enhancing coronary collateral circulation-alternate pathways by which blood can reach the heart muscle.

v. The procedure is performed in a series of outpatient treatments, in which inflatable cuffs wrapped around the legs inflate and deflate in rhythm with the patient's heartbeat.

vi. More than 100 published studies show that ECP can effectively relieve symptoms of heart failure, increase exercise tolerance, reduce reliance on medication, and improve quality of life. Benefits of treatment can last up to five years.

Warning! ECP is a medical device. United States Federal law restricts this device for use on or by the order of licensed physicians. The same applies to Malaysia.

While ECP may benefit many individuals suffering from the effects of coronary heart disease, it is not for every patient.

Contraindications for the therapy

i.Severe peripheral vascular disease

ii. Decompensated congestive heart failure

iii. Uncontrolled hypertension

iv. Phlebitis

v. Deep vein thrombosis

vi. Pregnant or potentially pregnant women

vii. Significant aortic insufficiency

viii.Markedly irregular heart rhythm

Consult with your registered physician who is trained and aware of ECP therapy to determine if ECP is an appropriate choice for you.

This novel therapy simulates the circulatory benefits of exercise, increase BMR, allowing patients to overcome symptoms and resume a healthy, active lifestyle.

Repairing the heart's blood supply

Regarded as a form of physical therapy, ECP stands in sharp contrast to the other, far more common approaches to angina; namely invasive interventions such as cardiac catheterisation, angioplasty, stent placement, and coronary artery bypass surgery.

Coronary artery disease is a progressive systemic disease, Invasive procedures don't address the underlying heart disease.

Atherosclerotic plaques can prevent blood flow to the heart muscle, resulting in oxygen starvation of the cardiac muscle tissue.

These clinical manifestations are often characterised by the pain of angina and some loss of cardiac function. But these blockages often become irrelevant .

ECP improves blood flow by improving blood vessel function as a whole. New pathways form.

The first time I heard about it, I thought it sounded too good to be true. But that was 11 years ago. Now, I am a firm believer in this deceptively simple therapy for the N0. 1 killer disease.

I was amazed by the science behind it and the simplicity of the technique.

In our Islamic culture, we always intend to think the higher-tech, the better, compared to the cheaper, safer, no-surgery approach.

But the results with this technique are phenomenal.

Reward from Almighty God depends upon our intention to please Him. Are we going to be greedy or be honest and serve our fellow human with sympathy?