What is EECP?
Enhanced External Counterpulsation (EECP) is a
non-invasive outpatient therapy that enhances
cardiovascular health for individuals
with angina, coronary artery disease, heart failure,
long COVID, and high-performance athletes.
It functions by improving the blood and oxygen flow to the heart muscle while decreasing its workload. During rest, specialized cuffs inflate sequentially from the calves to the thighs and buttocks, boosting blood flow to the heart's arteries. Just before each heartbeat, all cuffs deflate simultaneously, further reducing the heart's workload.
Yes! It is approved by the United States Food and Drug Administration (FDA) (Class IIb) for management of refractory angina and heart failure.
Research shows that EECP therapy not only improves quality of life and relieves symptoms such as chest pain, shortness of breath, and fatigue for up to three years after treatment, but also enhances cardiovascular function and decreases the need for hospitalization. Essentially, EECP therapy provides a non-invasive and effective solution for individuals facing angina and heart failure, promoting better cardiac health and overall well-being.
EECP personalized for you
If you are a patient with angina pectoris responding inadequately to anti-ischemic agents and coronary revascularization, who are inoperable or at high risk for operative complications or postoperative failure, who are poor candidates for PCI or CABG or continue to have disabling angina despite revascularization.
Or if you have done a PCI or CABG and is now eligible for EECP, as determined by your attending doctor, then this is for you.
Whilst the device is running sounds from the pumps will make it noisy, don’t be startled and be as relaxed as possible. we will also have soothing music or music of your preference playing for you to hopefully cover up the sounds of the device.
The cuffs will also start pumping and softening, this is determined by your heart rate. Be as still as possible so as to not interfere with the HR monitoring wires placed on you.
Clinically, some of the patient feedbacks we have received include extremities getting warmer, improved sleep quality and reduced frequency of nightmares, and enhanced mental clarity and capacity.
The clinical benefits of EECP extend beyond the time period of any acute hemodynamic beneficial effects. For example, the patients treated with EECP in the Multicenter Study of Enhanced External Counterpulsation reported a reduction in angina episodes and a decrease in nitrate use beyond the duration of therapy.
It is not fully understood why, after the EECP therapy is completed, patients remain improved, and the clinical benefits of the treatment persist for several years.
Our Dedicated Team
Dr. Lam Yat Yin
MBBS (HK), MRCP (UK), FHKCP, FHKAM (Medicine), FRCP (Glasg), FRCP (Lond), FRCP (Edin), FACC, MD (CUHK)
Dr. Lam Yat Yin is the founder and director of Centre Medical Group, also currently serving as the director of the Hong Kong Asia Heart Centre at Canossa Hospital (Caritas). Graduating with honours from the University of Hong Kong in 1999, Dr. Lam pursued specialized training in cardiology, encompassing general cardiology and percutaneous coronary intervention at the Prince of Wales Hospital in Hong Kong, as well as transesophageal echo imaging and structural intervention at the Royal Brompton Hospital in London.
Dr. Lam has served in various academic positions of several international conferences on congenital and structural heart disease in the Asia-Pacific region (such as LAA Hong Kong/Shanghai (2012), LAA Seoul (2013), CSI LAA Asia Pacific (2013 – 2017), APCASH (2013 – 2017) ), and has been invited to give academic lectures and surgical demonstrations to many countries in Europe, America, and Asia.
Dr. Lam also holds various positions, including Chairman of the Asia Pacific Structural Heart Club and leadership positions in various professional societies. He is also one of the founders of China Structural Heart Disease Week. In addition, Dr. Lam and Lifetech (Shenzhen) Co., Ltd. jointly developed the left atrial appendage occlusion device LAmbre™.
Dr. Lam is currently the associate editor of JACC Asia, the journal of the American College of Cardiology. He was also the deputy editor-in-chief of the International Journal of Cardiology – Cardiac Interventions, an authoritative international journal, and published more than 300 peer-reviewed research papers and abstracts.
Dr. Ivan Wong
MBBS(HK), MRCP(UK), FHKCP, FHKAM(Medicine), FACC
Dr WONG Man Ho, Ivan graduated from the University of Hong Kong and received his training in cardiology in Queen Elizabeth Hospital. He underwent further advanced training in structural heart interventions and interventional echocardiography at the Heart Centre, Rigshospitalet, Copenhagen, Denmark and Fudan University Zhongshan Hospital, Shanghai, China. Dr. Wong is the director of structural heart interventions, Hong Kong Asia Heart Centre. He is also a honorary clinical assistant professor at the Chinese University of Hong Kong. He also has other roles as a Council Member of Hong
Kong Society of Congenital and Structural Heart Disease. Former Associate Consultant,
Department of Medicine, Queen Elizabeth Hospital.
He has special interest in complex coronary and structural heart interventions. His research interest includes transcatheter aortic valve implantation (TAVI), left atrial appendage occlusion (LAAO) and intracardiac echocardiography (ICE) guided procedures. He established ICE-guided services in regional areas including Macau and Taiwan. He is the inventor of the LACRCO algorithm, SENTIPACE strategy and SISARI technique in the field of
interventional cardiology. He authored and co-authored book chapters and publications in peer-reviewed journals including JACC cardiovascular interventions and EuroIntervention. He is the co-author of the European consensus statement in the management of coronary
artery disease in patients undergoing transcatheter aortic valve implantation and the Chinese expert consensus statement on left atrial appendage closure in patients with atrial fibrillation.
EECP: A Natural Alternative for Bypass
During EECP, the blood flowing to your heart will naturally bypass arteries with significant plaque and instead enter healthy, non-diseased blood vessels, circumnavigating blockages. In time, these new pathways are reinforced and become lasting routes for blood to reach your heart beyond the blockages. This is why EECP is often referred to as a “natural bypass.”
What Our
Patients Are Saying
“The team is gentle, professional, and always make me feel comfortable”
May C.
“Dr. Lam is amazing! I finally found a cardiologist I trust!”
Chris L.
“The clinic environment is brightly lit and clean. Everything looks professional and well upkept. The staff all demonstrate exceptional professionalism too. Scheduling was seamless through whatsapp!
Chi Man C.
Benefits of EECP
Immediate improvements in angina and quality of life is observed after completion of a course of EECP treatment. In 95% of patients, these therapeutic benefits are sustained for 3 years.*
* Loh, P. H., Cleland, J. G., Louis, A. A., Kennard, E. D., Cook, J. F., Caplin, J. L., Barsness, G. W., Lawson, W. E., Soran, O. Z., & Michaels, A. D. (2008). Enhanced External Counterpulsation in the Treatment of Chronic Refractory Angina: A Long‐term Follow‐up Outcome from the International Enhanced External Counterpulsation Patient Registry. Clinical Cardiology, 31(4), 159–164. https://doi.org/10.1002/clc.20117
It works by enhancing blood and oxygen supply to the heart muscle while reducing its workload. During rest, specialized cuffs inflate from the calves to the thighs and buttocks, increasing blood supply to the heart's arteries. Just before the next heartbeat, all cuffs simultaneously deflate, further alleviating the heart's workload.
Evidence-Based Research Proven Benefits
FOR REFRACTORY ANGINA PATIENTS
- 78% : Reduced Angina Frequency. In patients with chronic stable angina.*
+25%: Increased total exercise time.
In patients with refractory angina pectoris **
Forces oxygenated blood toward the heart and coronary arteries while concurrently increasing the venous blood return to the heart under increased pressure.
FOR LONG COVID PATIENTS
-50%: Reduced breathing difficulties.*
-36%: Reduced fatigue.*
Eight proven domains of quality of life improved in the SF-36 survey.**
Relieving shortness of breath, increasing exercise tolerance, reducing inflammation, and improving dysautonomia—all commonly documented symptoms of long COVID.
FOR LONG COVID PATIENTS (cont.)
EECP Improves Post-COVID Shortness of Breath, Fatigue, and "Brain Fog”
EECP Successfully manages COVID-19-associated POTS (Postural Orthostatic Tachycardia Syndrome)
Extracorporeal counterpulsation therapy improves endothelial function and brain fog symptoms
* Soran O. Treatment options for refractory angina pectoris: enhanced external counterpulsation therapy. Curr Treat Options Cardiovasc Med. 2009 Feb;11(1):54-60. doi: 10.1007/s11936-009-0006-8. PMID: 19141261.
** Yin Q, Jiang H, Zhang Z, Zhang L, Wu Z, Huang L, Chen X. Influence of enhanced external counterpulsation on endothelial function: a meta-analysis of randomized controlled trials. Scand Cardiovasc J. 2023 Dec;57(1):2273223. doi: 10.1080/14017431.2023.2273223. Epub 2023 Oct 24. PMID: 37876280
* A study of 1,500 cardiac patients.
** Observational study of 16 long COVID patients. The study used a validated quality-of-life questionnaire called the Short Form Health Survey (SF-36). Patients reported significant improvements in all eight domains of the SF-36, including physical function, role limitations due to physical health problems, bodily pain, general health, vitality, social functioning, role limitations due to emotional problems, and mental health.
* Effect of enhanced external counterpulsation on aerobic performance and oxidative stress in trained cyclists" by Santos et al. (2012).
Our Locations
Zhao, M., Huang, Y., Li, L., Zhou, L., Wu, Z., Liu, Y., Zhang, H., & Hu, C. (2020b). <p>Enhanced External Counterpulsation Efficacy on Exercise Endurance in COPD Patients and Healthy Subjects: A Pilot Randomized Clinical Trial</p> International Journal of COPD, Volume 15, 25–31. https://doi.org/10.2147/copd.s225566
* Dayrit, J. K., Verduzco-Gutierrez, M., Teal, A., & Shah, S. A. (2021). Enhanced external counterpulsation as a novel treatment for post-acute COVID-19 sequelae. Cureus. https://doi.org/10.7759/cureus.14358
** Varanasi, S., Sathyamoorthy, M., Chamakura, S., & Shah, S. A. (2021). Management of Long-COVID Postural Orthostatic Tachycardia Syndrome with enhanced external counterpulsation. Cureus. https://doi.org/10.7759/cureus.18398
*** Enhanced external counterpulsation offers potential treatment option for long COVID patients - American College of Cardiology. (2022, February 14). American College of Cardiology. https://www.acc.org/About-ACC/Press-Releases/2022/02/14/14/25/Enhanced-External-Counterpulsation-Offers-Potential-Treatment-Option-for-Long-COVID-Patients
Sardina, P. D., Martin, J. S., Avery, J. C., & Braith, R. W. (2016). Enhanced external counterpulsation (EECP) improves biomarkers of glycemic control in patients with non-insulin-dependent type II diabetes mellitus for up to 3 months following treatment. Acta Diabetologica, 53(5), 745–752. https://doi.org/10.1007/s00592-016-0866-9
FOR LUNG FUNCTION
EECP Significantly Improved the Exercise Endurance of Normal Adults, Low Endurance Adults, and COPD Patients
FOR KIDNEY FUNCTION / RENAL DISEASE
EECP Effectively Clears Contrast Agent, and Reduces the Risk of Contrast-Induced Acute Kidney Injury
EECP Effectively Reduces Serum Creatinine in Patients with Combined CKD and DM post CAG/PCI, and Increases the Glomerular Filtration Rate
EECP Could Improve Long-Term Renal Function in Cardiac Patients
Sequential ECP Significantly Increases Carotid and Renal Blood Flow
EECP is an Effective Procedure to Augment Renal Excretory Function in Patients with Cirrhosis
FOR DIABETES
EECP Improves Glycemic Control in Patients With Type II Diabetes that Persist for Up to 3 Months following Treatment
FOR STROKE PATIENTS
*CUHK's 2012 study confirmed that EECP improves blood flow to brain and collateral circulation, thereby speeding up recovery of stroke patients. The results of this study have been published in the September issue of the American journal STROKE.
Enhancing tissue perfusion in the periinfarct cortex can promote neuroplasticity and facilitate functional recovery following a stroke, thereby strengthening the cortex. While treatments aimed at improving motor function support recovery, the impact of increased cerebral blood flow on cortical motor excitability has not yet been established.
Research is continually being conducted on humans.
*CUHK Proves External Counterpulsation Helps Augment Cerebral Blood Flow among Ischemic Stroke Patients. (2012, October 16). https://www.med.cuhk.edu.hk/press-releases/cuhk-proves-external-counterpulsation-helps-augment-cerebral-blood-flow-among-ischemic-stroke-patients
FOR HIGH-PERFORMANCE ATHLETES
+10%: Increased VO2 max*
- 25%: Reduced recovery time after exercise*
Clinically proven to significantly improve AT-VO2Kg, Max-VO2Kg, AT-O2puls, AT-Mets, and Max-Mets, increasing exercise endurance in participants of all fitness levels, including elite athletes.
* Dayrit, J. K., Verduzco-Gutierrez, M., Teal, A., & Shah, S. A. (2021). Enhanced external counterpulsation as a novel treatment for post-acute COVID-19 sequelae. Cureus. https://doi.org/10.7759/cureus.14358
** Varanasi, S., Sathyamoorthy, M., Chamakura, S., & Shah, S. A. (2021). Management of Long-COVID Postural Orthostatic Tachycardia Syndrome with enhanced external counterpulsation. Cureus. https://doi.org/10.7759/cureus.18398
*** Enhanced external counterpulsation offers potential treatment option for long COVID patients - American College of Cardiology. (2022, February 14). American College of Cardiology. https://www.acc.org/About-ACC/Press-Releases/2022/02/14/14/25/Enhanced-External-Counterpulsation-Offers-Potential-Treatment-Option-for-Long-COVID-Patients
FOR VARICOSE VEINS
EECP Improve Swelling and Cramps in Varicose Veins
* Çuğlan, B., Turhan, H., & Yetkin, E. (2022). Enhanced external counterpulsation effects on venous leg symptoms. The Anatolian Journal of Cardiology, 26(5), 401–406. https://doi.org/10.5152/anatoljcardiol.2022.1350