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Chapter-18 Enhanced External Counterpulsation and Its Clinical Applications

BOOK TITLE: Textbook of Cardiology (A Clinical & Historical Perspective)

Author
1. Gupta R
2. Mittal S
3. Srivastava S
4. Chopra HK
5. Kasliwal RR
6. Parashar SK
7. Manjuran RJ
8. Sambi RS
9. Aggarwal KK
10. Krishna CK
11. Bansal M
12. Nanda NC
ISBN
9789350900819
DOI
10.5005/jp/books/12259_18
Edition
1/e
Publishing Year
2013
Pages
10
Author Affiliations
1. University College of Medical Sciences and GTB Hospital, Delhi, Max Hospital, New Delhi, India, JROP Health Care; Max Hospital, New Delhi, India, Gandhi Medical College, Bhopal, Madhya Pradesh, India, J.L.N. Medical College, Ajmer, Rajasthan, India
2. Medical College, Baroda
3. University College of Medical Sciences and GTB Hospital, Delhi, Fortis Escort Heart Institute, New Delhi
4. Moolchand Medicity, New Delhi, India; National CSI Affairs; WWF, CSI 2015; Cardio Diabetes Update, AF Update, STEMI Update, CSI Cardiology Update 2014, Medanta Moolchand Heart Institute; Moolchand Medcity; World Wellness Foundation, WHA, Moolchand Medicity, New Delhi, India, IAE- 2017, CSI -2015; World Wellness Foundation, Physician Governing Body, CME, COP Moolchand Medcity, New Delhi, India; American Heart Association; Moolchand Medcity, IAE- 2017, CSI -2015; World Wellness Foundation; Physician Governing Body, CME, COP Moolchand Medcity, New Delhi, India;American Heart Association; Moolchand Medcity, IAE- 2017, CSI -2015; World Wellness Foundation; American Heart Association; Moolchand Medcity; Physician Governing Body, CME, COP Moolchand Medcity, New Delhi, India, IAE-2017, CSI-2015; World Wellness Foundation, Country Head, American Heart Association; Medanta Moolchand Heart Institute; Health Committee, SCOPE, Tata Sky FAM Health, New Delhi, India, Medanta Moolchand Heart Institute, New Delhi, India; CME
5. Medanta Heart Institute, Medanta–The Medicity, Gurgaon, Haryana, India, Medanta: The Medcity, Gurgaon, Haryana, India, Medanta Heart Institute, Medanta—The Medicity, Gurugram, Haryana, India, Medanta Heart Institute, Medanta–The Medicity, Gurugram, Haryana, India
6. SKS Medical College, Bhopal, Madhya Pradesh, India, Metro Hospital and Heart Institute, Lajpat Nagar, New Delhi, India; National CSI, Bhopal, Madhya Pradesh, India, Metro Heart Institute, New Delhi, India
7. Pushpagiri Institute of Medical Sciences and Research Center; Pushpagiri Heart Institute, Thiruvalla, Kerala, India, Pushpagiri Heart Institute, Pushpagiri Medical College, Tiruvalla, Kerala, India
8. National Heart Institute, New Delhi, India
9. Heart Care Foundation of India; Medical Education Moolchand Medcity, New Delhi, India; IJCP Group; Indian Medical Association; Ethical Committee, Delhi Medical Council, New Delhi, India, Board of Medical Education, Moolchand Medcity, New Delhi, India; eMedinews and IMA News; Indian Medical Association, BC Roy Awardee, Heart Care Foundation of India, New Delhi, India, Immediate National Past President,, Moolchand Hospital; Heart Care Foundation of India, Delhi, India, Board of Medical Education, Moolchand Medcity, New Delhi, India; eMedinewS and IMA News; Indian Medical Association BC Roy Awardee, Moolchand Medcity, New Delhi, India, Moolchand Medcity; Indian Medical Association; Heart Care Foundation of India, New Delhi, India
10. Moolchand Medcity, New Delhi, India
11. Medanta: The Medcity, Gurgaon, Haryana, India
12. University of Alabama, Birmingham, Alabama, USA; The Kirklin Clinic, University of Alabama Health Services Foundation, Birmingham, Alabama, USA
Chapter keywords
ischemic heart disease (IHD), vasodilator nitrates, coronary artery bypass graft, percutaneous coronary intervention, enhanced external counterpulsation, neurostimulation, transmyocardial laser revascularization, gene therapy

Abstract

The treatment of ischemic heart disease (IHD) has moved on gradually from the use of simple vasodilator nitrates to complex multiple medications and interventional procedures including coronary artery bypass graft (CABG) and percutaneous coronary intervention (PCI). Current treatments for IHD are able to decrease the incidence of morbidity and mortality in many patients. The current nonpharmacological treatment strategy available for refractory angina patients is enhanced external counterpulsation (EECP), neurostimulation (NS), percutaneous transmyocardial laser revascularization (TMR), percutaneous in situ coronary venous arterializations and gene therapy. Historical background and development of counterpulsation techniques are discussed. The contribution of researchers in the 1970s and late 1980s are described. The principle of mechanism, enhanced external counterpulsation, the effects of EECP, the indications and the contraindications are explained.

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