External Enhanced Counterpulsation
What is EECP?
EECP stands for external enhanced counterpulsation. It is a safe noninvasive outpatient treatment for heart disease. It is used to treat both angina and heart failure. During EECP treatments blood pressure cuffs are wrapped around your legs, which squeeze and release in sync with your heartbeat. This promotes blood flow throughout your body particularly to the heart, where it bypasses blockages.
How does it bypass blockages?
By stimulating release of nitric oxide, which opens up collateral circulation and dormant blood vessels allowing the blood to flow around blockages. In addition, EECP creates new blood vessels that also go around the blockages, which it does by the release of vascular endothelial growth factor, a growth factor for blood vessels. Not only that, EECP also stimulates the bone marrow to produce stem cells known as endothelial progenitor cells, which regenerate your arteries.
How does EECP help heart failure?
It does this in two ways. First it helps treat heart failure by strengthening the heart muscle and it does this simply by pumping more blood back to the heart. The more blood pumped back to the heart, the stronger it gets, this is called Starling’s Law a fundamental principle of cardiac physiology. This is similar to pumping iron at the gym-the more weight you lift, the stronger your muscle gets-the same is true for the heart muscle; the more blood returned to the heart, the stronger it pumps and the stronger it gets. EECP also increases blood flow to the kidneys and stimulates release of natural diuretic hormones that decrease fluid accumulation, which reduces the load on the heart.
What kind of success rates are seen with EECP?
The treatment results are actually quite amazing. EECP achieves practically unheard-of success rates of 80 to 90 percent. For patients with angina, EECP provides relief of chest pain, shortness of breath and fatigue. These patients have a much better quality of life, have more energy and improved exercise tolerance. They have less dependency on nitroglycerin and usually don’t need to use it anymore. They get their lives back again and are able to do things they haven’t been able to do for years. They have less need for future hospitalization, angioplasty, stents and bypass.
What are some of the advantages of EECP?
First of all, it’s important that we understand that heart disease is not just about blockages. Heart disease is a systemic condition and not simply localized to one or more coronary arteries; it effects the whole vascular system-all 60,000 miles of blood vessels from your brain to the tip of your toes. Truly effective management of heart disease calls for treating the entire cardiovascular system, not merely one or two vessels. EECP does just that; while it bypasses the blockages it also treats the entire vascular system.
Without attempting to discredit the truly life-saving interventions of bypass surgery, angioplasty and stents; these procedures are only designed to eliminate isolated blockages in coronary blood vessels. Plus, there is a certain degree of risk with these procedures. Whereas, EECP is noninvasive, carries no risk and is or needles involved.
What are some of the other positive effects of EECP?
Besides bypassing blockages, creating new blood vessels and strengthening the heart, EECP causes the release of nitric oxide, which has an antioxidant and relaxing effect on your arteries. EECP reduces arterial stiffness, prevents plaque buildup and reduces inflammation in blood vessels. Since it is now well accepted that inflammation is a key underlying cause of heart disease, this anti-inflammatory effect is highly relevant. By improving blood flow to the liver and kidneys EECP removes toxic metabolites and has a detoxification effect. It reduces stress and has been shown to decrease anxiety and depression in patients with heart disease. And to top it off, you get the benefits of one hour of exercise while simply lying there. The positive effects are quite comprehensive. There is no other medical intervention that is comparable.
What about patients who can’t lower their cholesterol because of a genetic disorder or simply because they won’t change their diet, would EECP be of any help to them?
I think that EECP would most likely be quite beneficial for two reasons:
First-It is well accepted that high cholesterol and especially high LDL cholesterol are associated with heart disease, which is due to their role in causing inflammation of blood vessels, plaque formation and subsequent blockages. Since EECP reduces inflammation in blood vessels and can also bypass the blockages, it seems quite reasonable to think that it would retard some of the effects of high cholesterol and help prevent plaque formation.
The second reason is because of a very interesting study done on pigs.
In this study, the investigators took three groups of pigs. One group got the standard diet that pigs are fed; the control group. The other two groups were both put on a high cholesterol/high fat diet. One of these high cholesterol groups was treated with EECP and the other was not. So, both study groups ate the same high cholesterol/high fat diet, but one was treated with EECP and the other was not.
At the conclusion of the study biopsies of the blood vessels in all three groups were done. The blood vessels in the control group had moderate cholesterol deposits and early plaque buildup. And as you might expect the high cholesterol group that did not have EECP had a lot more cholesterol deposits, plaque buildup and the blood vessel cells were very disarrayed compared to the control group. Amazingly the high cholesterol group that had EECP had no evidence of cholesterol deposits, no plaque buildup and the cells were perfectly aligned. This positive effect of EECP is due to what is known as shear force.
EECP reduced the harmful effects of a high cholesterol diet in pigs. Whether or not we would get the same effect in humans isn’t known, but it would seem likely that the effects would be similar, since blood vessels in pigs and humans are basically the same.
What is shear force?
Shear force or shear stress is the dragging force or friction generated by blood flow. As EECP pumps your blood it induces a relatively high physiological shear stress on the blood vessel lining called the endothelium. We get several major benefits from this effect.
First, shear force stimulates the production of nitric oxide, which has an antioxidant and relaxing effect on blood vessels. Secondly, this shear stress has anti-inflammatory effects on blood vessels. Thirdly and perhaps most importantly, shear stress prevents adhesion molecules and white blood cells from sticking to the endothelium, so it prevents plaque buildup and subsequent blockages. In a nutshell, shear force keeps blood vessels relaxed, open, free of inflammation and prevents plaque buildup. There is no other medical treatment that comes close to doing all this. EECP stands alone in its unique ability to treat all of this effectively and safely.
Could EECP be beneficial for people without heart disease?
Think about it, if EECP can help people with heart disease, including patients with end-stage coronary vascular disease, wouldn’t it be good for someone who is healthy or at least appears to be healthy? Might it not make them even more healthy? Could it improve athletic performance and give the athlete an edge? There is some evidence that it does.
EECP improves blood flow to every organ and cell of the body, which delivers oxygen and nutrients while it removes toxic wastes. It has the potential of preventing vascular and age-related diseases like no other. In my opinion, it is the ultimate preventive health maintenance and wellness tool and has profound longevity and antiaging potential. It may be the most advanced preemptive treatment available today and happens to be a scientifically proven and FDA approved safe technology. The treatment is practical, makes sense and uses the body to heal itself. What could be more natural?
Are there other conditions that EECP is being used for?
Yes, the potential is exciting and the list is growing.
EECP is being used for a wide variety of conditions including peripheral vascular disease, restless leg syndrome, peripheral neuropathy and sudden hearing loss and tinnitus. It has been used to treat stroke survivors because it improves blood flow to the brain, so patients recover faster and more completely. The Chinese use it for dementia and Alzheimer’s because it improves blood flow to the brain. There are reports of it helping Parkinson’s disease patients.
EECP is especially beneficial for diabetics since they are at very high risk of coronary vascular disease. Diabetics tend to have blockages that are widespread and located in smaller arteries that are often difficult or even impossible to treat with invasive procedures.
EECP is being used to treat erectile dysfunction. Men have to wake up to the fact that erectile dysfunction is probably an early sign of heart disease. So, men that are taking Viagra or Cialis may be getting improvement in their ability to get erections, but they are not addressing the underlying cause, which may be heart disease. Remember, heart disease is a systemic problem. The blood vessels supplying the penis are smaller than those that supply the heart and heart disease may show up as erectile dysfunction first.
Has there been much published research about EECP?
One thing I really feel good about recommending EECP is the science behind it, which is solid, extensive and impressive. EECP has gone through clinical trials at major universities and medical centers resulting in well over 100 scientific publications in mainstream journals, such as Journal of Internal Medicine, American Journal of Cardiology and the Journal of Cardiovascular Medicine.
EECP has been FDA approved since 1995 to treat coronary artery disease, angina, cardiogenic shock and to use during a heart attack. In 2002, it was approved by the FDA for congestive heart failure. Medicare approved treatment of it for angina in 1999.
Tell us more about the procedure, how is it administered?
The actual treatment process is ingenious in its overall simplicity. During EECP treatments you lie on a special bed with a series of blood pressure cuffs wrapped around your legs. You are hooked up to a sophisticated computerized EKG, which triggers the cuffs to inflate and deflate in sync with your heart beat. During the resting phase of the heart, the cuffs inflate, pumping oxygen rich blood back to the heart. Then when the heart pumps, the cuffs rapidly deflate and the blood vessels expand so blood gets ejected from the heart with less work for the heart muscle. You get all the benefits of a second heart pumping between each heartbeat.
The procedure is not painful- you feel a strong "hug" sensation as the cuffs inflate upward over your calves, thighs and buttocks. It’s like a deep tissue massage of your lower body.
The sessions last one hour and are usually given five days a week for seven weeks for a total of 35 treatment sessions. Some patients may need more than 35 treatments depending on the severity of their condition. At our clinic high levels of oxygen are administered during the treatment.
Why administer oxygen? Isn’t the EECP treatment by itself enough?
You could say that oxygen is our most vital nutrient. It is an indisputable fact that lack of oxygen leads to death rather quickly. However, oxygen has a role in our lives beyond just life and death. Oxygen insufficiency may express itself over a spectrum ranging anywhere from mild fatigue or brain fog to life-threatening illness. The main characteristic of aging manifests as a gradual reduction in our physical and mental abilities, which is basically due to a lack of energy. When our cells don’t have enough oxygen, they are unable to produce the energy required to stay healthy, which leads to increased degenerative processes and susceptibility to disease.
One of the reasons I was influenced to use oxygen was due to a statement made by Dr. Arthur Guyton, probably the foremost medical physiologist of our time. He wrote “The Textbook of Medical Physiology” used by medical and graduate students throughout our nation. Dr. Guyton said, “All chronic pain, suffering and diseases are caused from a lack of oxygen at the cell level”. A rather profound statement indeed and enough to persuade me to treat patients with high levels of oxygen while they do EECP.
Could you summarize the key benefits of EECP treatment?
EECP increases blood flow to your heart by opening collateral circulation and creating new blood vessels, while at the same time it strengthens your heart. It keeps your blood vessels relaxed, open and prevents plaque buildup.
EECP reduces arterial stiffness and releases nitric oxide, which has an antioxidant and anti-inflammatory effect, which makes arteries resistant to spasm and clotting. It has a detoxification effect and increases lymphatic circulation.
EECP improves exercise tolerance, increases blood flow to the brain, improves sleep, inhibits development of arteriosclerosis, improves well-being and has a longevity-antiaging affect. EECP has a relaxing anti-stress effect and has been shown to decrease anxiety and depression. You get the benefits of one hour of aerobic exercise while simply lying there.
There is no other medical intervention that comes close to doing all this. EECP stands alone in its unique ability to positively effect so many bodily functions plus it is a scientifically safe and proven technology. It is the most advanced preventive health maintenance and longevity promoting system available today.
Testimonials
Previous Bypass/Multiple Stent Patient
"I have had over 50 EECP treatments and I cannot thank you enough for your kindness and caring attention each and every time. Progress has been slow but worth the time, since surgery was the only offer available with the cardiology doctor in Mt. Vernon, WA.
My angina has gone from being a daily and painful anticipation to almost forgetting it was there. I can now bathe without stopping to sit and take Nitro or going downstairs to do my laundry and clean my house and I live alone! Thanks again for letting me see my veins again in my hands and feet and restoring them to normal color instead of white feet and purple toes.
I hope other doctors follow your approach to offering hope beyond surgery and drugs. Thanks again to you, your staff, you patients and your work are in my prayers."
Ronald A. Meyer Sr.
Multiple Chemical Sensitivity
"The biggest change I've experienced with EECP treatment is overall quality of life improvement. As a person with multiple chemical sensitivities, nervous system degradation, peripheral vasculitis and several immune system issues, my quality of life had deteriorated. Living day to day became increasingly dependent on vigilant avoidance of ordinary substances in our environment that triggered nasty whole body reactions. Detoxification became increasingly difficult.
EECP assists my body in pumping oxygen into my cells and all my systems seem to have improved as a result. I have more energy, am less sensitive to chemicals, sleep better and find that my body is able to detox faster. And, very importantly, EECP is non-invasive. An added bonus is that my insurance company reimburses me for half of the treatment cost.
I am very grateful to Dr. David Buscher for having the insight to understand that his patients could benefit from having better-oxygenated cells through EECP. I certainly did."
Cheers, Pat Waterston
Chronic Fatigue Syndrome
"During the 31 years I have had ME-CFS (Chronic Fatigue Syndrome) and Fibromyalgia, only a few treatments have significantly reduced the effects of my symptoms. EECP is one of them. From the first treatment, I knew EECP would help me. Immediately, my cognition and memory seemed much clearer, my mood became more optimistic and I was happier, and I noticed my stamina and energy were increased. Further treatments have sustained these gains.
On a practical level EECP makes a big difference in my life. At home are the difficulties and confusion of deciding what to do every day as well as the to-do list to make sure I remember everything. When I wake up in the morning, I look forward to the day without being depressed or over-whelmed. Before EECP, it took all evening for me to empty the waste baskets and put out the garbage; now I can do it in less than an hour.
I have also experienced unanticipated positive side effects. My muscles are so relaxed, I can now turn my head enough to look directly out the back window of my car when I am backing out of the driveway instead, of having to rely exclusively on the car's rear view mirrors. And, after years of needing a pick up tool to retrieve anything off the floor, I can now stretch and bend easily enough to use my hands.
EECP is not the cure, but it has so improved my quality of life that I will continue to do half-hour treatments every week.
I whole-heartedly recommend EECP without reservation to anyone who wants to overcome some of the major limitations of ME-CFS and Fibromyalgia."
Louis H. Janson
If you want to learn more about EECP, I highly recommend Heal Your Heart with EECP by Debra Braverman, M.D.. This is a good read, well documented and acomplete description of EECP; it's history, the science and amazing beneficial effects.