Introduction Enhanced external counterpulsation (EECP) is a modality developed to improve symptoms of chronic stable angina; however patients with permanent pacemakers (PPM) or implantable cardiac defibrillators (ICD) have been excluded from clinical trials because it is felt to be a contraindication to effective counterpulsation. We report the effective use of EECP in 28 patients with PPM or ICD and we compare the results of major adverse cardiac events MACE at one year to the patients in the international EECP registry.
Methods Patients with chronic stable angina from angiographically proven coronary artery disease and reduced ejection fractions with PPM and ICD who were pacemaker dependent were treated with 35 hours of EECP. Twelve patients were paced in DDD mode, one in VDD, eight in VVI, and seven in DDIR. Two patients in DDR mode required alteration to DDD mode because of muscle stimulation during EECP treatment and medications were not altered.
Findings After treatment the PPM and ICD treated patients had similar reduction in angina when compared to the IEPR database. MACE was similar between the two groups.
Conclusions We conclude that EECP is both safe and effective for the treatment of angina pectoris patients with PPM or ICD in pacing mode. (Table)