Old idea meets new technology

Ideas behind improving blood flow began in the early 1950s, and by the mid 1960s, the first device for enhanced counterpulsation was developed. Although effective, the device was largely overlooked because of the emergence of coronary bypass surgery and angioplasty. The technique was refined over the next two decades, and by 1995, EECP therapy became available to patients outside of clinical studies.

A non-invasive treatment gives heart patients an unexpected second chance

Ask Margaret Champ to walk the halls of University of Iowa Hospitals and Clinics, and not only can she walk them, the 76-year-old great-grandmother can help draw a guide through the many twists and turns.

A year ago, Champ's response would have been very different. A painful burning in her throat and chest made it difficult for her to complete even her daily most routine activities. "I was weak," she said. "I just couldn't walk very far."

That burning was caused from angina, the most common symptom of coronary artery disease. Affecting more than 7 million Americans, angina occurs when vessels that carry blood to the heart muscle become narrowed or blocked, decreasing the supply of blood and oxygen to the heart.

As her burning increased, Champ's primary doctor in Ottumwa, Stanley Blew, M.D., referred her to physicians with UI Heart and Vascular Center. With one quadruple bypass surgery already behind her, doctors advised Champ that another surgery would be too risky. Champ decided that she'd take her chances without it.

Last summer, on a routine visit with UI Heart and Vascular Center cardiologist Ellen Gordon, M.D., at an outreach clinic in Ottumwa, Champ mentioned a treatment her daughter in Florida had recently heard about. Gordon was well-aware of the treatment known as Enhanced External Counter-Pulsation® (EECP) and thought it was just what Champ needed.

Unlike other procedures, EECP is non-invasive and, therefore, more appropriate for patients unable to undergo surgery. "We can help a certain population that didn't have many other options," said Catherine Pesek Bird, D.O., assistant professor and medical director of the EECP Program.

Similar to the way a flood forces a river to form new channels, EECP stimulates the opening of new blood vessels by increasing blood flow through the coronary arteries.

During treatment, compressive cuffs are attached to the patient's calves, lower thighs, and upper thighs. The cuffs are inflated and deflated sequentially to improve blood flow to and from the heart. The entire treatment consists of 35 one-hour sessions usually given five days a week for a seven week period.

In addition to the actual treatment sessions, patients are also encouraged to improve their daily lives. "We're helping them change their lifestyles," said EECP program manager Tina Clair who works directly with patients while they are receiving treatment. "We want them to move more."

In conjunction with UI Heart and Vascular Center's Cardiovascular Health, Assessment, Management, and Prevention Service (CHAMPS), EECP patients improve their overall physical fitness. For Champ, that meant ridding herself of the wheelchair she needed to arrive at her treatments and slowly walking the halls in the hospital. Within a matter of weeks, Champ and her daughter were making their own rounds in the hospital. "We had them all mapped out," Champ said.

"You start to ask yourself, 'How can this be? This works so well,'" said CHAMPS director Patrica Lounsbury, R.N. Not only is Lounsbury able to see the visible progress of patients, but she can also objectively document their improvement through various cardiopulmonary tests. "There's no way to fake those tests," she said.

And the effect seems to last. Most patients receiving EECP require only one full course of treatment before seeing a reduction in angina. "We're excited about what we're doing here," said Bird.

Today, Champ walks more than 30 minutes a day, something she never would have dreamed of a year ago. "I was just willing to try anything, and it worked for me," she said. "Each day is a blessing."

Old ideas meets new technology
Ideas behind improving blood flow began in the early 1950s, and by the mid 1960s, the first device for enhanced counterpulsation was developed. Although effective, the device was largely overlooked because of the emergence of coronary bypass surgery and angioplasty. The technique was refined over the next two decades, and by 1995, EECP therapy became available to patients outside of clinical studies.

For more information about EECP, patients and families should contact UI Health Access and ask for Tina Clair, EECP program manager. Physicians seeking consultation or referral should call UI Consult.

Heart patient Margaret Champ goes mall-walking as part of her exercise commitment following treatment by Enhanced External Counter-Pulsation (EECP).

Catherine Pesek Bird, D.O., (left), is medical director of the Enhanced External Counter-Pulsation therapy program, and Tina Clair, an exercise physiogist with traning in EECP therapy, serves as manager.

For more information, please call UI Heart and Vascular Center Clinic, 319-356-4346.