External Enhanced Counterpulsation

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Maximize Your Health and Well-Being with EECP
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Numerous clinical trials in the last two decades have shown EECP therapy to be safe and effective for patients with refractory angina with a clinical response rate averaging 70-80%, which is sustained up to five years.  In patients with heart failure is not only safe, but also is shown to improve quality of life, increase exercise capacity and improve left ventricular function long-term.  EECP is also being used for restless leg syndrome, erectile dysfunction, sudden deafness, hepatorenal syndrome and Parkinson's disease. (Journal Of the American College of Cardiology 2007).

External Enhanced Counterpulsation (EECP) is FDA approved for treating angina and is used by more than 800 physicians in the US including those at leading medical centers such as Mayo Clinic, Johns Hopkins and the Cleveland Clinic. Besides angina, the treatment has been proven to benefit patients with congestive heart failure, a condition where the heart can't pump sufficient blood to meet the needs of the rest of the body.  Heart failure is one of the fastest growing cardiovascular diseases in the US, nearly 5 million Americans have heart failure and over a half-million new cases are diagnosed each year.

What Exactly Is EECP and how is it administered?

EECPThe 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 computerized EKG system, which triggers the cuffs to inflate and deflate in sync with the heart beat.  During the resting phase of your heart, the cuffs inflate, pumping oxygen rich blood to your heart and throughoutthe rest of your body.  When your heart pumps, the cuffs rapidly deflate, then 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 will feel a strong "hug" sensation as the cuffssequentially inflate upward over the calves, thighs and buttocks.

Treatment sessions last one hour. High levels of oxygen are administered during the treatment. Patient's usually listen to music, read, relax and some even fall asleep. Treatments are administered to patients on an outpatient basis usually on a daily basis. The number of treatments depends upon the medical condition. Angina and heart failure patients  require at least 35 treatments.

How does EECP bypass blockages?

By opening up collateral circulation, which are dormant blood vessels that get "woken up" during EECP. So the blood flows around blockages; "bypassing blockages". EECP also creates new blood vessels that go around the blockages. It does this by releasing VEGF, a growth factor for blood vessels. Amazingly it also stimulates the bone marrow to produce stem cell endothelial progenitor cells, which create brand new blood vessel cells that line your arteries.

What kind of success rates are seen with EECP?

The treatment results are amazing. EECP achieves practically unheard of success rates of 80-90 percent. For patients with angina EECP provides relief of chest pain, shortness of breath and fatigue. Patients treated with EECP have more energy, improved exercise tolerance and have less dependency on nitroglycerin and usually don't need nitroglycerin anymore.  These  patients have a much better quality of life. They get their lives back again and can do things they haven't been able to do for years. They have less overall need for hospitalization, angioplasty, stents and bypass.

What are some of the advantages of EECP?

First of all, it's important we understand that heart disease is not just about blockages.  Heart disease is a systemic condition and not simply localized to one or two coronary arteries; it effects the whole vascular system-all 60,000 miles of blood vessels from your brain to the tip of your toes.  We need to treat the entire system not merely open up one or two vessels.  EECP treats the entire vascular system as it bypasses blockages; it doesn't merely treat blockages. Bypass surgery, angioplasty and stents no doubt can be lifesaving, but only 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 administered as an outpatient. There are no injections, intravenous catheters or needles involved.

How does EECP help heart failure?

EECP helps treat heart failure because it strengthens 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. in addition, EECP stimulates the heart muscle to release a natural diuretic, which decreases fluid retention.

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 major contributor to heart disease, this anti-inflammatory effect is highly relevant.  EECP also has a detoxification effect and increases lymphatic circulation.  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 lying there. The benefits are wide-ranging and truly remarkable.

Are There Any Side Effects or Risks to EECP?

EECP is very safe. Some patients find the pressure uncomfortable when they first start, but eventually adapt to it. Occasionally the skin gets irritated, but adding more padding where needed reduces this problem. Some patients feel tired after the first few treatments, but after that they almost always feel more energized.

Is EECP safe if I already had bypass, angioplasty or stent?

Yes. In fact, EECP has been approved by Medicare for the treatment of angina patients whose condition is inoperable or for those who invasive procedures failed or were ineffective.

Does EECP have lasting benefits?

Studies have shown that three to five years after treatment, the benefits of EECP have continued. Patients have either no or less chest pain, less use of nitroglycerin and documented improved blood flow.

How does EECP compare with angioplasty or bypass surgery?

Studies have shown that after five years the outcome for EECP patients is about the same as angioplasty and bypass.

Who should not have EECP?

EECP should not be done under the following conditions: pregnancy, severe aortic insufficiency, uncontrolled high blood pressure, abdominal aortic aneurysm, open wounds, deep vein thrombosis (blood clots in legs), hemophilia, high fever.

Can I do EECP if I'm taking Coumadin?

Yes. Taking Coumadin is not a contraindication to doing EECP safely.

Does EECP detoxify the body?

EECP has a detoxification effect by increasing in the removal of metabolic waste products from cells and by increasing circulation to the kidneys and liver, which clear the body of toxins. Keep in mind that the flow of blood not only delivers vital substances to the cells, it also "washes out" metabolic debris and environmental toxins. The increased pressure from EECP pumping action drives oxygen and nutrients into cells more effectively.

What about patients who can't lower their cholesterol because of a genetic disorder or are unable to tolerate statin drugs? Would EECP be of any help to them?

This is an interesting question. I think that EECP would most likely be very beneficial. I say this for two reasons.

First-It is fairly well accepted that high cholesterol and especially high LDL cholesterol is associated with heart disease, which is probably due to a combination of blood vessel inflammation, plaque formation and subsequent blockages. Since EECP reduces inflammation in blood vessels and bypasses the blockages, it seems quite reasonable to think that it would retard some of the effects of high cholesterol.

The second reason is because of a very interesting study done using 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 fed the same high cholesterol diet. One of the high cholesterol diet groups was treated with EECP and the other was not. So both groups ate the same high cholesterol 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 normal diet group had cholesterol deposits and early plaque buildup. As you might expect the high cholesterol group that did not have EECP had a lot more cholesterol deposits , plaque build up and the blood vessels cells were very disarrayed compared to the control group. But the high cholesterol diet EECPgroup had no evidence of cholesterol deposits, no plaque build up 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 very pretty much identical.

What do you mean by shear force?

Shear force or shear stress is the dragging force or friction generated by blood flow.  EECP induces a relatively high physiological shear stress on the endothelial lining of the blood vessel. 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.  Shear stress also has anti-inflammatory effects on blood vessels.  And thirdly shear stress prevents adhesion molecules and white blood cells from sticking to the blood vessel lining and by doing so it prevents  plaque buildup and 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 what EECP does.  EECP stands alone in its unique ability to effectively treat so many aspects of the entire cardiovascular system.

What is the Endothelium?

With all that being said, perhaps the most important benefit from EECP is what it does for our endothelium.  The endothelium is the innermost lining of our arteries; it is only one cell thick and is comprised of about one trillion cells.  It is about 60,000 miles long, has the surface area of six tennis courts, weighs more than our liver and is one of the largest and heaviest organs in our body.

One of the many functions of the endothelium is regulating the diameter of the blood vessel.  EECP stimulates the endothelial cells to produce nitric oxide.  Nitric oxide naturally dilates blood vessels and also has a proven antioxidant effect. Nitric oxide is one of the most important substances in our body having profound effects on our cardiovascular, immune and central nervous system.  The Nobel Prize in Medicine or Physiology 1998 was awarded for discoveries about the effects of nitric oxide.

EECP also suppresses blood vessel inflammation. Not only is inflammation a major factor in cardiovascular disease; it also plays a role in other chronic diseases including arthritis, Alzheimer's, Parkinson's, and other conditions.

Why do you also administer oxygen to these patients? Isn't just the EECP treatment itself enough?

Although oxygen is not typically administered at most EECP centers I decided that it would be a good addition, since most people I test have low levels of oxygen in their veins, which indicates a cellular oxygen deficiency.

Oxygen is our most vital nutrient. It is indisputable that a lack of oxygen leads to death rather quickly.  However, oxygen has importance in our lives beyond just life and death. Mild oxygen deficiency may express itself over a broad range of conditions;anywhere from mild fatigue to life-threatening illness.  One of the main signs of aging manifests as a gradual reduction of energy and decrease in our physical and mental abilities, which is basically due to a lack of oxygen. When our cells don't have sufficient amounts of oxygen, they lack the vitality they need to be healthy.  They become more susceptible to disease and degeneration whether they are in the heart, liver, brain or any other organ.

One of the reasons I was influenced to use oxygen was because of 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 and the compelling reason that persuaded me to administer high levels of oxygen while patients go through EECP.

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 peripheral vascular disease, erectile dysfunction, sudden hearing loss and tinnitus, restless leg syndrome and peripheral neuropathy.  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 anecdotal reports of it helping Parkinson's disease patients.

EECP is beneficial for diabetics because they are at high risk of coronary artery 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 has been shown to reverse the effects of type 2 diabetes without making any changes in diet, physical activity or medication.

Some clinics use EECP to treat erectile dysfunction. Men have to wake up to the fact that erectile dysfunction is probably an early sign of heart disease. So all the men that are taking Viagra or Cialis may be satisfied with the results, but are not addressing the underlying cause, which is 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 there first.

What about the average person, would EECP be beneficial?

Think about it, if EECP can help people with heart disease, including patients with end-stage coronary vascular disease, wouldn't it also be good for someone who is healthy or at least appears to be healthy? Might it not make them even more healthy?  EECP improves blood flow to every organ and cell of the body, which delivers oxygen, nutrients and removes toxic wastes. It has the potential of preventing vascular diseases and age related diseases like no other.  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 safe technology.  The treatment is practical, makes sense and uses the body to heal itself.  What could be more natural?

Why do you consider EECP regenerative therapy?

The benefits of EECP extend well beyond the time period of the hemodynamic effects it produces. This prolonged clinical benefit is not fully understood, but suggests that EECP has a regenerative effect. Studies have shown that EECP increases the level of circulating hematopoietic progenitor cells and endothelial progenitor cells. Progenitors cells are stem cells. They are multiptent stem cells they give rise to all blood cell types including erythrocytes, lymphocytes, neutrophils, macrophages, T cells, B cells and natural killer cells. Endothelial progenitor cells create new blood vessels.

Endothelial progenitor/stem cells repair the lining of the blood vessels. Hematopoietic progenitor cells are multipotent stem cells that give rise to all blood cell types such as neutrophils, macrophages, erythrocytes, platelets and lymphoid cells. Lymphoid cell lineages include T-cells, B-cells and natural killer cells.

In other words, these stem cells regenerate the cardiovascular system, the immune system and create new red blood cells and platelets!

Would EECP help promote longevity and wellness?

The foremost degenerative process is age and can be defined as a reduction in circulating stem cells. Since EECP has been shown to increase the level of circulating stem cells, it is likely to slow the effects of aging. By keeping the blood flowing to all organs oxygen and nutrients delivered to the cells, which helps "keeps them alive".

Why wait until we are diagnosed with heart disease or other degenerative conditions?

EECP offers not only therapeutic benefits, but amazing potential to prevent or at least slow the onset of many of the diseases that are so prevalent in modern-day living.  EECP would slow the aging process. I believe that as we age our microcirculation gradually closes down slowing the flow of blood, oxygen and nutrients to our cells. Without sufficient oxygen and nutrients cells gradually become less efficient and die.

We have over 60,000 miles of blood vessels in our body, which pulsate with our heartbeat an average of 100,000 times a day. The blood and cardiovascular system are an ongoing miracle bringing life to our body.  Take care of them.

Has there been much published research on EECP?

Another thing that is great about EECP is the science behind it, which is solid and extensive. EECP has gone through clinical trials at major universities and medical centers resulting in well over 100 scientific publications, 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.

Could you summarize the key benefits of EECP treatment?

EECP increases blood flow to your heart by opening up collateral circulation and creating new blood vessels, while at the same time it strengthens your heart. It keeps your blood vessels relaxed, open, free of inflammation and prevents plaque buildup.

EECP reduces arterial stiffness and releases nitric oxide, which has an antioxidant effect making arteries resistant to spasm and clotting. It  has a detoxification effect and increases lymphatic circulation.

EECP has a relaxing anti-stress effect and has been shown to decrease anxiety and depression in patients with heart disease. You get the benefits of one hour of exercise while simply lying there. There is no other medical treatment that comes close to doing all this.  EECP stands alone in its unique ability to effectively treat all of these issues safely and effectively.


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.