What is Enhanced External Counter-Pulsation (EECP)?
Enhanced External Counter-Pulsation (EECP) is a non-invasive therapy for chronic stable angina or chest pain. It uses pressure in the lower limbs to improve blood flow in people with long-term symptoms of heart disease like chest pain. It is a non-invasive, outpatient treatment. EECP can reduce the need for medication and allow patients to be more active without experiencing any symptoms.
How is Enhanced External Counter-Pulsation (EECP) being done?
EECP is a non-invasive procedure. The treatment is administered through three pairs of external inflatable cuffs that are applied around the lower legs, upper leg and buttock. These cuffs will continuously inflate and deflate during the procedure. The cuffs will inflate and deflate in between the resting period of the heartbeat, this will increase blood returned to the heart which allows more oxygen to the heart. Patients who are on enhanced external counterpulsation therapy will receive treatment over seven weeks.
Who is eligible for Enhanced External Counter-Pulsation (EECP) therapy?
Eligible for EECP if:
- Long term chest pain that comes and goes during physical exercise and stress
- Chest pain not relieved with medications
- Not suitable /fit to undergo any form of heart procedure/surgery
- Still experience chest pain after bypass surgery, angioplasty or stenting
Besides chest pain / stable angina, EECP also helps in these conditions:
- Cerebrovascular disease
- Heart failure
- Kidney failure
- Lung disease
- Peripheral vascular disease
EECP cannot treat unstable angina where patients usually experience chest pain even during resting.

Who should not undergo Enhanced External Counter-Pulsation (EECP) therapy?
Patient with the following conditions is not suitable or should not undergo enhanced external counterpulsation (EECP) therapy:
- Atrial fibrillation (AF)
- Blood clots issue
- Congenital heart disease
- Hemorrhage
- Hypertrophic cardiomyopathy
- Pulmonary hypertension
- Patient who has a pacemaker
- Heart rate >120
- Severely elevated blood pressure
How long is EECP therapy?
One complete cycle of treatment for enhanced external counterpulsation required a total of 35 hours. Patient needs to commit for one hour per day for five days a week for a total of seven weeks.
What are the advantages of Enhanced External Counter-Pulsation (EECP) therapy?
Enhanced external counterpulsation therapy help to improve patient life quality by:
- Increased energy
- Less frequent symptoms of chest pain
- More ability to be active without chest pain/symptoms
- Reduce the need for medications
What is the risk or complications of Enhanced External Counter-Pulsation (EECP) therapy?
Most people don’t experience any major side effects or discomfort. EECP is a very safe procedure with minor or no complications. Common side effects patients might experience are:
- Fatigue
- Muscle ache
- Joint discomfort
- Numbness or tingling sensation
- Bruises or edema