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Health Information Center

Enhanced External Counterpulsation

  • Cynthia M. Johnson, MA
Publication Type:


Enhanced External Counterpulsation



Enhanced external counterpulsation (EECP) uses inflated cuffs on the legs to help push blood back to the heart.

The Cardiovascular System.

EECP pushes blood back toward the heart to reduce the heart's workload.

cardiosystemhttp://services.epnet.com/getimage.aspx?imageiid=82018201AL00005_cardiosystem.jpgAL00005NULLjpgcardiosystemNULL\\hgfiler1\intellect\images\AL00005_cardiosystem.jpgNULL15NULL2011-08-25400156Copyright © Nucleus Medical Media, Inc.

Reasons for Procedure

EECP is used to treat angina. This is chest pain caused by poor blood flow to the heart. EECP can increase the amount of blood going to the heart. This can decrease the workload of the heart and ease pain.

EECP may be done in people who are not helped by other methods.

EECP may also be used to treat people who have heart failure.

Possible Complications

Problems are rare, but all procedures have some risk. The doctor will go over some problems that could happen, such as:

  • Excess bleeding in people with thin blood
  • Worsening of heart failure—in people who have certain heart rhythm problems

People who are pregnant or have any of these health problems should not have EECP:

What to Expect

Problems to Look Out For

Call the doctor if you are not getting better or you have:

  • Nausea or vomiting
  • Tingling, pain, swelling, or bruising in the legs
  • Numbness or tingling in the shoulder, arm, or wrist
  • Chest pain
  • Problems breathing
  • Symptoms that come back or worsen

If you think you have an emergency, call for medical help right away.

Prior to Procedure

The care team may meet with you to talk about:

  • Any allergies you may have
  • Current medicines, herbs, and supplements that you take and whether you need to stop taking them before EECP


Anesthesia is not needed. EECP is not painful.

Description of Procedure

Electrodes will be placed on the chest to watch heart rhythm. Blood pressure will also be checked.

Cuffs will be placed on the calves and thighs of the legs. The cuffs attach to air hoses. The cuffs will inflate and deflate in rhythm with the heart. There will be strong pressure from the cuffs. The cuffs will inflate 60 to 80 times each minute during the treatment.

How Long Will It Take?

Total treatment time is 35 hours. It will be spread out over 7 weeks.

Will It Hurt?

No. It is common to feel tired after EECP. It will go away over time.

Post-procedure Care

At the Care Center

Right after the procedure, the staff will remove the electrodes and cuffs.

At Home

You will be able to go back to your normal activity levels. Lifestyle changes will need to be made to improve blood flow to the heart.





  • Angina. National Heart Lung and Blood Institute website. Available at: http://www.nhlbi.nih.gov/health/health-topics/topics/angina. Accessed October 20, 2020.
  • Angina (chest pain). American Heart and Stroke Association website. Available at: https://www.heart.org/en/health-topics/heart-attack/angina-chest-pain. Accessed October 20, 2020.
  • Enhanced external counterpulsation (EECP). Cleveland Clinic website. Available at: http://my.clevelandclinic.org/heart/disorders/cad/eecp.aspx. Accessed October 20, 2020.
  • Management of stable angina. EBSCO DynaMed website. Available at: https://www.dynamed.com/management/management-of-stable-angina.


  • Daniel A. Ostrovsky, MD
Last Updated:

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.