External Counter Pulsation (ECP)

Yati Mediquip
Yati Mediquip   Ph. 9811518571, 01164634367

 

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What Is ECP

Rounded Rectangle: What Is ECP External Counterpulsation therapy is a non-invasive technique employing sequential inflation of three sets of lower extremity cuffs during diastole, with deflation at the onset of systole. Counterpulsation Therapy increases venous return, augments diastolic pressure and provides presystolic unloading. Counterpulsation provides benefits of decreased anginal frequency, improved exercise tolerance and improved stress myocardial perfusion in patients with chronic angina. It has been postulated from its similarities to the IABP that the hemodynamic effects of Counterpulsation result in collateral recruitment and/or development.

What Is Special About YM - 7

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  • Simply Effective

New YM - 7  ECP System combines proven medical technology with  styling in a compact model that’s easy to operate. As a result, therapists use it with confidence and physicians rely on its performance. All information during therapy is displayed on one screen, without complicated pulldown menus, mouse-pointers, or keyboard entry. Just touch the controls to set timing and pressure parameters, print waveform tracings, and start/stop therapy. 

  • Automated Process For Easy Operation And Better Treatment.

YM – 7is user friendly and provides more effective treatment by automatically determining the optional inflation and deflation timing and by incorporating a feedback control loop to regulate the air tank pressure. He advanced system design reduces the time and effort to train and operator and produces consistent and effective treatment  that does not rely on a machine operator’s judgment.

  • More Safety Features

In addition to other safety features available in other  ECP devices.

  1. YM-7 releases air pressure automatically on detecting missing ECG signal.

  2. More pressure sensors assure that the applied pressure is stabilized around the preset  value during treatment.

  3. Insulation transformer is employed in the system to further protect the patient and operator from power failure or surge.

  4. And many more…

 

Advantages

  • Less or elimination in  chest pain (Angina)

  • Less Ventricular Fibrillation

  • Decrease or elimination in shock symptoms

  • Decrease in heart size

  • Less progression in cardiac failure

  • Afterload reduction

  • Increase in quality of life

  • Decrease in mortality rates

  • Decrease in hospital admissions

 FDA Status

  Counterpulsation is FDA cleared for: Angina Pectoris, Acute MI and Cardiogenic  Shock. FDA 510(k) approval #K872034 date 09/18/87.

INDICATIONS FOR USE

YM - 7 Therapy Systems is non-invasive external counterpulsation device intended for use in the treatment of patients with stable or unstable angina, congestive heart failure, acute myocardial infarction, or cardiogenic shock.
 

Contraindications

  •  Arrhythmias that interfere with machine triggering.

  •  Bleeding diathesis .

  •  Active thrombophlebitis.

  •  Severe lower extremity vaso-occlusive disease .

  •  Presence of a documented aortic aneurysm requiring surgical repair .

  •  Pregnancy .

Features

 

Triggering Method

Precise, R-Wave generated

Trigger Range : 32-125 bpm

 

YM-7 Treatment Bed

36" Wide Treatment Bed

Electrically adjustable bedrest (500Kg.)

0-45 adjustment range

 

Voltage Requirements

120V/AC/60Hz, 20A

230V/AC, 50 Hz, 10A

 

Integrated Blood Pressure

Pressure - range

Systolic 90 to 220mmHg

Diastolic 46 to 140mmHg

Accuracy +/-5mmHg (Standard Deviation 8mmHg or less)

 

Filter Technique

Low-pass digital filter eliminates 50/60 Hz and high frequency interference.

 

Transport / Storage Environment

Temperature : 20 to 120 F (-6 to 50 C)

Relative Humidity : 25 to 90 %

Atmospheric Pressure : 500 to 1060

 

Treatment pressure Range

Adjustable from 0 to .45 Kg.

 

System Protection

One main circuit breaker

 

Patient Protection

Automatic inflation stop and release of pressure on early extra systole.

Automatic treatment stop and pressure release if power outage occurs

Automatic high pressure limit.

Auto treatment stop heart rate exceeds 125bpm or drops under 32bpm.

 

Cuffs

2 Sets are provided with the machine.

One size is fit for all calf, thighs & buttocks.

 

Recommended Operating Environmenent

Temperature : 50 to 140 F (10 to 40 C)

Relative Humidity : 30 to 70%

Atmospheric Pressure : 700 to 1060 hPa

Atmosphere : Free of corrusive gas.

 

History of ECP
 

In 1950 'Kantrowitz and Kantrowitz' first described the principle of "phase shift" diastolic augmentation.

Soroff, et al,* related this principle to the oxygen consumption difference between flow work and pressure work by the heart. It was this understanding that eventually led to the concept of a mechanically induced counterpulsation to provide assistance to patients with low cardiac output syndromes.

Direct counterpulsation techniques first developed by Harken and associates at Harvard resulted in femoral cut-down and external pulse actuation. The technique withdrew and then returned the blood to the arterial system. Studies documented increased coronary flow, decreased coronary AVO2 difference and reduced left ventricular pressure work.
* Soroff, et. al., 1965

 

About us 

Yati Mediquip  develops, manufactures and markets quality medical devices that help non-invasive cardiology therapy and rehabilitation professionals better serve their patients. We are now applying our expertise for product innovation and customer care to the ECP therapy equipment market. With the YM- 7 system, Yati Mediquip is proud to offer the most versatile, powerful and affordable ECP product available anywhere.

 

Contact Us

YATI MEDIQUIP

197, Pocket D-2

Opp. CSC-5 DDA Market.

Sector - 11, Rohini

New Delhi-110085

Phone : 09811518571,  011- 64634367.

FAX: 011- 27298234

E-mail : cardiocareindia@rediffmail.com

 

Ask The Doctor

Q: What is angina?
A: Angina is the global term for all symptoms associated with coronary artery disease, which occurs when the heart is not receiving enough blood. It occurs when vessels that carry blood to the heart muscle become dysfunctional, and are often narrowed or blocked. Angina may feel like chest pain or pressure, shortness of breath, pain in the jaw, neck, arms, back, nausea, or generalized fatigue. Each patient experiences angina differently.

Q: What does ECP stand for?
A: The acronym ECP stands for  External Counterpulsation.

Q: What is ECP?
A: ECP is a non-invasive, outpatient treatment for heart disease that is used to relieve or eliminate angina. During the treatment, blood pressure cuffs are wrapped around your legs, and squeeze and release in sync with your heartbeat, promoting blood flow throughout your body and particularly to your heart. In the process, ECP develops new pathways around blocked arteries in the heart by expanding networks of tiny blood vessels (“collaterals”) that help increase and normalize blood flow to the heart muscle. For this reason, it is often called the natural bypass.

Q: What are the advantages of ECP?
A: Unlike bypass surgery, balloon angioplasty, and stenting procedures, ECP is non-invasive, carries no risk, is comfortable, and is administered in outpatient sessions.

Q: Are there any risks or side effects of ECP?
A: ECP is safe. Occasionally, some patients experience mild skin irritation under the areas of the blood pressure cuffs. Experienced ECP therapists address this irritation by using extra padding where needed to make the patient comfortable. Some patients experience a bit more fatigue at the beginning of their course of treatment, but it usually subsides after the first few sessions. In fact, patients typically feel energized by ECP.

Q: How long does ECP take?
A: The standard course of treatment is one hour per day, five days per week, for seven weeks (a total of 35 one-hour sessions). Some patients have two treatments in one day in order to complete the program more quickly. Some patients extend the program beyond 35 treatments, depending on their particular medical situation and goals.

Q: When can I expect to start feeling better from ECP?
A: Most patients begin to experience beneficial results from ECP between their 15th and 25th treatments. These benefits include increased stamina, improved sleeping patterns, decreased angina, and less reliance on nitroglycerin and other medications. There is variation, certainly, and some patients start to feel better as soon as their first week of treatment!

Q: What happens if I miss a treatment?
A: You are encouraged to come for your ECP treatment everyday. However, missing a day will not have a negative effect on your overall results. When you come back, you will simply pick up where you left off, and the missed treatment will be added to the end of your program until you have a total of 35 sessions. Just like exercise, the more consistent you are with your ECP schedule, the better your results will be.

Q: What does ECP feel like?
A: ECP feels like a deep muscle massage to your legs. During the treatment, you do not feel anything in the chest or heart. You only feel the cuffs that are wrapped around your legs squeezing in time to your own heartbeat. Our patients have affectionately described this sensation as “gentle hugs.” Most of our patients relax, listen to music, or read during their treatments. Some even sleep!

Q: Do the benefits of ECP last?
A: Yes. In patients followed for three to five years after treatment, the benefits of ECP, including less angina, less nitroglycerin usage, and improved blood flow patterns documented on stress tests, had lasted.

Q: How does ECP compare to angioplasty or bypass surgery?
A: The five-year outcomes for ECP patients are virtually the same as for angioplasty and bypass surgery patients.

Q: Is ECP FDA-approved? What kind of research has been done on it?
A: ECP was approved by the FDA in 1995 as a treatment for coronary artery disease and angina, cardiogenic shock, and for use during a heart attack. In 2002, the FDA approved ECP as a treatment for congestive heart failure. It has undergone rigorous clinical trials at leading universities around the country and ECP has been the subject of more than 100 scientific studies published in leading medical journals throughout the world.

Q: I have a pacemaker. Is that a problem with ECP?
A: No. Pacemakers and internal defibrillators do not interfere in any way with ECP.

Q: I am on Coumadin. Is that a problem with ECP?
A: No. Patients on Coumadin are able to undergo ECP treatments safely.

Q: I have congestive heart failure (CHF). Is that a problem with ECP?
A: No. In fact, in July 2002 the FDA approved ECP as a treatment for congestive heart failure (CHF). After completing a course of ECP treatment, patients with CHF typically have less swelling in their legs, less shortness of breath, less fatigue, and often require less diuretic medication.

Q: Is there an age limit for ECP?
A: No. We have successfully treated patients as young as 36 and as old as 97 without any difficulties. Many of our patients are in their 80s and 90s and complete the entire ECP program with excellent results.

Q: I have already had bypass surgery/angioplasty/stents. Can I still have ECP?
A: Yes! Most of our patients have already had one (or many) of these procedures. They come for ECP treatment because they still have angina.

Q: Can ECP dislodge plaque and cause a stroke or heart attack?
A: No. Our bodies obey the laws of physics, and one principle law is that fluid will follow the path of least resistance. Atherosclerotic plaques are calcified and hard, and they create an obstruction that detours the blood through alternate routes. During ECP, when your blood is flowing to your heart, it will naturally bypass arteries with plaque and enter healthy, non-diseased blood vessels to go around the blockages. Going around the blockages is a longer trip, but it is a much easier one. In time, these new pathways are reinforced and become lasting routes for blood to reach your heart beyond the blockages. Every ECP patient has had multiple, serious blockages. No one has ever had a heart attack or a stroke as a result of the treatment.

Q: Are there any patients who are not able to have ECP?
A: There are very few patients who are unable to have ECP. Those who should not be treated include pregnant women, individuals with a severe leakage in their aortic valve requiring surgical repair, and patients with an active blood clot in their leg.

Q: I had a blood clot in my leg three years ago. Can I have ECP?
A: Yes. Having a history of a blood clot (deep venous thrombosis or DVT) in your leg does not preclude you from having ECP. It is recommended that you have a Doppler ultrasound of your leg to confirm the blood clot has resolved before beginning the ECP program.

Q: Does ECP aggravate high blood pressure (hypertension)?
A: No. If you have hypertension that is properly managed, you may undergo ECP without difficulty. Oftentimes, patients with hypertension find that their blood pressure improves as they proceed with ECP. If your hypertension is uncontrolled, you must seek medical care to get your blood pressure under control with proper medications before proceeding with ECP.

Q: I have bad circulation in my legs (peripheral vascular disease or PVD). May I still have ECP?
A: Yes, and you should! ECP improves blood flow throughout the entire body, including your legs. If you have poor leg circulation, you might need more than 35 treatments. My patients typically require at least 50 treatments to get the full benefit of the program. In addition to improved stamina, less angina, and less nitroglycerin use, patients with PVD have a marked improvement in their leg circulation in response to ECP.

Q: I have atrial fibrillation and an irregular heartbeat. May I still have ECP?
A: Yes. An irregular heartbeat, including one caused by atrial fibrillation, will not interfere with ECP if the heart rate is controlled and no faster than 100 beats per minute.

Q: I have varicose veins. May I still have ECP?
A: Yes. Varicose veins are typically a cosmetic issue, not a medical one. As such, they do not preclude individuals from receiving ECP. We often use extra padding in patients with varicose veins to ensure maximum comfort.

Q: What happens if my angina returns months or years after I finish my ECP treatment course? Can I come back for more?
A: Yes. ECP is not a once-in-a-lifetime treatment. Heart disease is a chronic illness and symptoms may return at some point in the future. The door is always open for you to return for additional courses of ECP as needed.

Q: Is ECP similar to chelation therapy?
A: No. There is no relationship between ECP and chelation therapy. Chelation is an invasive procedure whereby a substance called EDTA is given intravenously in an attempt to bind to calcium and remove it from atherosclerotic plaques. The fundamental problem with the concept of chelation is that atherosclerotic plaques are not only made of calcium; they include fat, cholesterol and cellular deposits as well. Chelation is a technique which has never been shown by scientific research to have any therapeutic value for heart disease. Since it has never been proven to work, chelation is not paid for by Medicare or any insurance carrier, and therefore is not accessible to most heart disease patients.  Chelation can actually be harmful – even fatal – when administered to the wrong person or under the wrong circumstances. It poses particular danger to individuals with congestive heart failure. The amount of fluid administered with each treatment may overtax their weakened heart, leading to severe fluid overload and problems including pulmonary edema (a life-threatening condition in which there is an excess of fluid in the lungs).

In contrast, ECP is entirely non-invasive, proven by hundreds of published scientific studies, and safe. It is an accepted, mainstream medical treatment and, as such, is approved by Medicare and covered by insurance. Chelation does not interfere with ECP, so you may undergo both simultaneously if you choose.

 

Clinical Studies

More than 100 articles and studies on ECP have been published in leading cardiology journals, all supporting the treatment's safety and effectiveness. We hope you find this sampling helpful, and we will continue to update this section as often as possible.