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Enhanced external counterpulsation (EECP)--a promising new therapy for angina--is now FDA cleared for treatment of heart failure.

"This is basically placing timed balloon inflations on the legs," says cardiologist Dr. Douglas Zipes. "What it does is milk the blood flow backwards. It sounds kind of crazy, but good people have good data, and it does look like it works."

EECP was approved to treat angina in 2000 after studies found that participants who received 35 hours of the therapy experienced fewer episodes of chest pain and were able to exercise for longer periods. In the new study, patients with congestive heart failure who were treated with EECP showed a significant improvement in their functional capacity and quality of life.

During the outpatient treatment, long cuffs are wrapped around the patient's legs and inflated and deflated with each heartbeat. The milking action of the leg cuffs reduces the heart's workload and increases blood flow to arteries which supply the heart muscle. Unlike most arteries, the coronary arteries receive their blood flow after each heartbeat instead of during each beat. In most cases, patients receive five one-hour EECP sessions per week, for seven weeks.

A larger, randomized clinical trial will provide more definitive data on the benefits of EECP for patients with heart failure. Results of the Prospective Evaluation of EECP in Congestive Heart Failure (PEECH) trial are expected later this year. Look for more on this innovative therapy in a future issue.