THIRUVANANTHAPURAM, 7 June 2008 — Kerala-based Med.Links Cardiocare Private Limited has introduced the Enhanced External Counter Pulsation (EECP) treatment, which helps treat cardiac patients nonsurgically without risk, for the first time in the state.

“If you have heart disease, you probably know all about statins (cholesterol-lowering medications) and beta blockers (blood pressure medication), angioplasty and bypass surgery, and the benefits of regular exercise,” explains Dr. Ajith Joy K., the chief executive officer. “What is to be done when all these treatments fail or when someone is not fit for the above treatments? About 30 percent of all cardiac patients are in this category and they live on suffering with chest pain, mobility restriction, severe breathlessness, swelling on the feet, etc. The EECP could be an approved treatment method for them.”

The idea behind this wacky-sounding treatment is to decrease the demand on an ailing heart by helping it push blood through the body. According to the team of doctors at the Med.Links, the EECP diminishes the symptoms of ischemia.

In numerous studies, EECP has been shown to relieve angina, improve exercise tolerance, and decrease the degree of ischemia in a cardiac stress test.

“The EECP works amazingly well to relieve chest pain for most patients. Patients who have undergone surgery but still suffer from chest pain and breathlessness and those who have symptoms even after optimal medical management and post-angioplasty can be helped by this treatment,” he said.

First approved by the Food and Drug Administration in 1995, EECP is most often used in patients with stable angina, the kind that often lasts five minutes or less, is brought on by physical exertion and is usually relieved by drugs like nitroglycerin.

“Unfortunately, stable angina isn’t always easily controlled with medications, and some people just aren’t good candidates for angioplasty or surgery. That’s where EECP comes in,” said Dr. Joy.

Patients lie down during the procedure, which lasts an hour, and is performed once a day, five times a week, for seven weeks. The 35 hours of nonsurgical outpatient-based treatment where pneumatic cuffs like BP cuffs are placed around the calves, thighs and buttocks, timed to inflate in progression.

Starting with the section around the calves, when the heart reaches its resting phase between beats, as each cuff inflates, it squeezes blood out of the legs and back to the heart. The cuffs are timed to inflate and deflate based on the individual’s electrocardiogram.

“It feels like a deep muscle massage,” says Dr. Joy, who administers EECP to patients here. “The most common side effect is chafing of the skin, usually prevented by wearing elastic clothing”.

The cost comes to around $6,000, which is much lower compared to $60,000 for bypass surgery. The treatment involves no surgery, no needles, no hospital admission or no pain. Atrial fibrillation is a relative contraindication, because the varying heart rate makes it impossible to time the inflation and deflation of the cuffs. In the subset of individuals with atrial fibrillation, high degree heart block, and a permanent pacemaker who are pacemaker dependent, it may still be possible to perform EECP.

“Intriguingly, recent studies suggest that the heart responds to this extra flow of blood by producing tiny blood vessels called collaterals naturally bypassing the blocked blood vessels to better nourish the heart. That is why the benefits of EECP often last 5-6 years in 87 percent of the treated patients,” he says.

The EECP may also be useful in other hard-to-treat conditions like heart failure. It’s US FDA approved and is currently used in over 1500 centers in the USA and about 20 centers in India. That may change to a situation where it may be present in most households, as the benefits of squeeze therapy become better known among the medical community.