Cardiovascular Disease (CVD) is the world’s number one killer today. According to the World Heart Federation, it kills 17.5 million people a year across the globe and by 2030 this is predicted to rise to nearly 23 million. CVD results in 1 in 10 deaths among persons aged 30-70 years and 31% of all deaths are from CVD.

In Sri Lanka, Heart Bypass surgery has been widely used for treating patients suffering from Coronary Artery Disease (CAD). However, not everyone is physically able to withstand a Bypass surgery as it is demanding on the human body. As a viable alternative to Bypass surgery, Consultant Cardiologist Dr. Gotabhaya Ranasinghe recommends a therapy that has been introduced to Sri Lanka and has been globally used for decades. The treatment, named EECP (Enhanced External Counter Pulsation), is a non-invasive, non-surgical procedure for heart patients.

Dr. Gotabhaya Ranasinghe is a Consultant Cardiologist at the National Hospital of Sri Lanka and also Honorary Consultant Cardiologist to the Sri Lanka Navy holding the rank of Surgeon Rear Admiral. He is a leading general and interventional Cardiologist in the country.

Following are excerpts of an interview with Dr. Ranasinghe, where he elaborated on EECP therapy.

Q: What is EECP therapy?

A: EECP stands for Enhanced External Counter Pulsation and has been approved by the United States Food and Drug Administration (FDA). It is a non-invasive, non-surgical and outpatient medical therapy for the treatment of angina, congestive heart failure, acute myocardial infarction and cardiogenic shock.

Numerous trials across the world have shown EECP therapy to be safe and effective for patients with refractory angina with clinical response rate averaging 70-80%, which is sustained up to 5 years. EECP helps to grow new collaterals for blood flow, like a natural bypass around blocked arteries.

Q: Who is it for?

A: Bypass surgery is not for everyone. EECP therapy is ideal for patients who can’t undergo Bypass surgery but want the same or better benefits. So, they should look at EECP therapy as a viable alternative.

 Q: In which countries is EECP therapy currently used?

A: Since this is a US FDA-approved therapy, it meets international medical standards. Therefore, it can be found all over the world. Some of the main countries and regions include USA, Europe, China, Russia, Middle East, India, Singapore and Pakistan. Sri Lanka has started this a bit late but that means we have a very good understanding of the best way to use this new therapy for our patients.

Q: How does EECP therapy work?

A: EECP therapy consists of a system of three sets of inflated pressure cuffs wrapped around the calves, thighs and hips of the patient. These cuffs are rapidly inflated and deflated in sync with the patient’s heartbeat. Using a heart monitor, the cuffs sequentially inflate with air when the heart relaxes and deflate when the heart pumps. The timing of the inflation and deflation makes it easier for the heart to pump and increase blood supply to the heart. In doing so, EECP develops new pathways around blocked arteries in the heart by expanding networks of tiny blood vessels, also called collaterals, that help increase and normalize blood flow to the heart muscle. For this reason, it is often called the Natural Bypass by medical experts.

Q: What are the steps to be taken before and after the therapy?

A: Before the therapy, a Cardiologist has to assess and see if the patient is suitable for this treatment. He’ll need to undergo a few tests such as ECG, blood tests, kidney function and heart function and then the Cardiologist will recommend the treatment based on the test results. After the therapy period is over, he talks to the patient and doesa scan and an exercise ECG to see if the heart function has improved. It’s also important that the patients continue their medication so that they get the best results.

Q: How is the EECP therapy carried out and how long does it last?

The treatment is administered to the patients on an outpatient basis. Usually it happens daily in 1-hour sessions, 6 days per week for a total of 35 treatments. The procedure is well tolerated and under this suggested regimen, approximately 75% of patients experience relief of symptoms caused by their coronary artery disease following the course of the treatment.

Q: How does EECP affect the heart?

A: EECP causes immediate and sustained increase in the heart’s blood supply by dilating coronary blood vessels, opening dormant or unused collateral levels, stimulating the release of growth factors and establishing shunts from other vessels.

Photo Caption

1.Consultant Cardiologist at the National Hospital of Sri Lanka Dr. Gotabhaya Ranasinghe

2. EECP therapy is ideal for patients who can’t undergo bypass surgery