Expert consensus on the clinical application of enhanced external counterpulsation in elderly people (2019).

Shen Lin,Wu Gui-Fu,Wang Xiao-Ming

doi:10.1002/agm2.12097

Abstract

Enhanced external counterpulsation (EECP) is a non‐invasive assisted circulation technique and a rich pool of evidence has accumulated for its clinical application in the prevention and management of multiple comorbidities in the elderly population, including angina, heart failure, ischemic cerebrovascular diseases, neurodegenerative diseases, sleep disorder, diabetes and its complications, ischemic eye diseases, sudden hearing loss and erectile dysfunction, as well as various psychological and psychiatric conditions. When applying EECP to elderly patients, emphasis should be placed on issues such as safety assessment, risk management and protocol individualization, as well as the monitoring of efficacy during and after treatment.

Highlights

Enhanced external counterpulsation (EECP) is a non-invasive assisted circulation technique, which employs electrocardiogram-gated sequential inflation of cuffs wrapped around calves, thighs and buttocks, which inflate and deflate during the cardiac cycle
The MUlti-center STudy of Enhanced External Counter Pulsation (MUST-EECP) is the first multi-center, prospective, randomized controlled trial that studied the effect of EECP on stable angina patients, of whom over 70% had received percutaneous coronary intervention (PCI) or coronary bypass grafting (CABG), 51% had a history of myocardial infarction (MI), 70% reported Canadian Cardiovascular Society (CCS) grade II or III symptomatic angina, 65% had multi-vessel coronary artery disease
(1) Coronary artery disease: a standard protocol of EECP is recommended for patients with angina, post-MI, post-PCI, post-CABG, non-obstructive coronary artery disease; (2) Heart failure: a standard protocol of EECP is recommended for chronic stable heart failure of ischemic origin (NYHA grade II to III)

Summary

Introduction

Enhanced external counterpulsation (EECP) is a non-invasive assisted circulation technique, which employs electrocardiogram-gated sequential inflation of cuffs wrapped around calves, thighs and buttocks, which inflate and deflate during the cardiac cycle. Subsequently applied in various conditions including heart failure, ischemic cerebrovascular diseases and so on, with documented evidence of benefits.[1-4] Improvements in diabetes, ischemic eye diseases, sudden hearing loss, male erectile dysfunction, sleep disorders, etc have been reported.[5-10] As a safe, non-invasive and effective treatment, EECP has attracted interest from geriatricians who care for elderly with multiple comorbidities.

Results

Conclusion