Munson Health
Enhanced External Counterpulsation

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by Kerr SJ




Enhanced external counterpulsation (EECP) is a treatment for chronic, stable chest pain known as angina . Angina happens when there is not enough blood and oxygen being pumped to the heart to support the work it is doing. It may also be used to treat certain people with heart failure .
Cuffs, similar to blood pressure cuffs, are placed on the legs. These cuffs inflate and deflate with air to the rhythm of the heart. This helps to push blood back toward the heart, increasing blood flow. Since circulation is improved, the heart does not have to work so hard.
The Cardiovascular System
EECP pushes blood back toward the heart to reduce the heart's workload.
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What to Expect

Prior to Procedure

Before you begin EECP, your doctor may:
  • Discuss your medical history
  • Discuss any medications you are taking—your doctor may not recommend EECP if you take blood thinners
  • Answer any questions you have about the procedure
You may want to wear tight-fitting, seamless pants. This can help prevent chafing from the cuffs.


You will not be given any anesthesia. EECP is not painful.

Description of Procedure

You will lie on a padded table. Electrodes will be placed on your chest to monitor your heart rhythm. Your blood pressure will also be monitored.
Cuffs will be placed on your calves and upper and lower thighs. The cuffs attach to air hoses that will inflate and deflate them in rhythm with your heart. You will feel a strong “hug” from the cuffs, beginning at your calves and moving to your upper thighs. The cuffs will inflate 60-80 times each minute during the treatment.

How Long Will It Take?

You will be treated for a total of 35 hours. Treatments are usually given each day over seven weeks.

How Much Will It Hurt?

EECP is not painful. You may feel uncomfortable when the cuffs tighten on your legs.


American Heart Association

National Heart Lung and Blood Institute



Canadian Cardiovascular Society

Heart and Stroke Foundation of Canada



Amin F, Al Hajeri A, Civelek B, et al. Enhanced external counterpulsation for chronic angina pectoris. Cochrane Database of Systematic Reviews. 2010;2:CD007219.

EECP: what is enhanced external counterpulsation (EECP)? Heart Healthy Women website. Available at: . Accessed August 7, 2013.

Enhanced external counterpulsation. Cleveland Clinic website. Available at: . Updated January 2010. Accessed August 7, 2013.

Enhanced external counterpulsation (EECP). The Ohio State University Medical Center Heart and Vascular center website. Available at: . Accessed August 7, 2013.

Explore angina. National Heart Lung and Blood Institute website. Available at: . Updated June 1, 2013. Accessed August 7, 2013.

What is angina? American Heart and Stroke Association website. Available at: . Published 2012. Accessed August 7, 2013.

Manchanda A, Soran O. Enhanced external counterpulsation and future directions: step beyond medical management for patients with angina and heart failure. J Am Coll Cardiol. 2007;50(16):1523-1531.


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