Can enhanced external counter pulsation as a non-invasive modality be useful in patients with ischemic cardiomyopathy after coronary artery bypass grafting?

Abstract

BackgroundAngina symptom in patients with ischemic cardiomyopathy (ICM) after coronary artery bypass grafting (CABG) surgery is a major challenging problem in practice. The choice among different treatment modalities available can be judged by different parameters especially measuring the risk/cost ratio to achieve the benefit. Enhanced external counter pulsation (EECP) is one of safest noninvasive modality for treatment of angina as well as it has an anti-failure effect.Patients and method42 patients with ICM after CABG were suffering from stable angina and were treated at Al-Hayat Cardiology Centre in Tanta City (ACC). 20 patients of them (group A) received 35 sessions of EECP plus their anti-ischemic and anti-failure treatment, while the other 22 patients (group B) received only medical treatment and were followed up for 3 months regarding their angina class, functional class, frequency of angina attack, frequency of sublingual nitrate and rate of rehospitalization when needed during follow up period.ResultsDespite both groups had nearly similar severity of symptoms regarding the CCS class and NYHA class, yet patients in group A experienced significant improvement in comparison to patients in group B (p-value = .005, p-value = .002 respectively), and this was reflected on frequency of angina and need for sublingual nitrates per week which showed significant decrease in group A (p-value = .001).ConclusionAs a non-invasive treatment modality EECP is very effective in improving the symptoms of angina and heart failure when combined with medical treatment in patients with ICM after CABG.

https://researchopenworld.com/brief-review-of-enhanced-external-counter-pulsation-eecp/#

“…EECP was shown to be effective in treating angina in patients with ischemic cardiomyopathy after CABG [11] although this is a small study with only 40 subjects. More studies are needed in this group of patients before it can be formally recommended.…”

Predictors of adherence of enhanced external counterpulsation in patients with coronary heart disease after discharge: A mixed-methods study

“…Importantly, in the qualitative results, we also found that patients with angina were more likely to have negative attitude, they had a wrong understanding that angina pectoris is an incurable disease, such practical issues need to be considered. In fact, they did not know that 35 h course of EECP has been shown to relieve angina attacks and reduce the use of nitroglycerin, which may also be related to a lack of physician advice and encouragement (34,35). The intensity of physician encouragement was reported to be a key factor in determining patients to participate and adhere to cardiac rehabilitation (36).…”