Informative Insight
Contraindications
There are certain situations where EECP therapy may not be appropriate or where caution should be exercised. Individuals who fall into the following categories may not be suitable candidates for EECP therapy:
- Severe Aortic Valve Disease: Individuals with severe aortic valve disease, such as severe aortic stenosis, aortic insufficiency, or aortic regurgitation may not be suitable candidates for EECP therapy due to the potential risk of worsening symptoms or complications. In addition, the compromised valve may not allow adequate blood flow, negating the benefits of EECP.
- Severe Heart Failure: Acute Heart Failure or Decompensated Heart Failure is not recommended for EECP therapy. It is advised that patients with heart failure consult with their physician/cardiologist for medical advice if they are suitable for EECP therapy.
- Severe Peripheral Artery Disease: Individuals with severe peripheral artery disease (PAD) or significant arterial blockages may not be suitable candidates for EECP therapy. This includes individuals with limiting peripheral vascular disease involving the ilio-femoral arteries.
- Pregnancy: EECP therapy is not suitable for pregnant individuals due to the lack of safety data regarding its use during pregnancy and the potential risk to the foetus.
- Severe Lung Disease: Individuals with severe lung disease or pulmonary hypertension may not be suitable candidates for EECP therapy due to the potential risk of worsening respiratory symptoms or complications.
- Individuals with an active Deep Vein Thrombosis (DVT) and thrombophlebitis: EECP therapy may not be recommended for individuals with active deep vein thrombosis (DVT) or a history of blood clots due to the potential risk of dislodging clots and causing complications.
- Patients undergoing major Anti-Coagulation Therapy (such as Heparin therapy or Coumadin® therapy) with prothrombin time (PT) > 1.5
- Bleeding disorders or in the use of anticoagulants with unadjusted INR Results: EECP involves the use of inflatable cuffs that compress the blood vessels in the legs. This compression could potentially lead to trauma or injury to the blood vessels, increasing the risk of bleeding in individuals with bleeding disorders.
- Individuals with severe hypertension (≥ 180 mm Hg systolic or ≥110 mm Hg diastolic).
- Uncontrolled arrhythmia or controlled arrhythmias that could interfere with EECP inflation and deflation triggering.
- Dual chamber pacemaker: Atrial pacing may interfere with EECP inflation timing sequence
- Any surgical intervention within 6 weeks before EECP treatment.
- Cardiac catheterisation within 2 weeks before EECP treatment.
- Presence of a burn, open wound, local infection or bone fracture on any limb subject to EECP treatment.
- Abdominal Aortic Aneurysm
- Severe cardiac valve regurgitation
- Vasculitis of the extremities
- Heart rates less than 35 or greater than 125 beats per minute (BPM)
It’s important for patients to undergo a thorough evaluation by a healthcare provider to determine if EECP therapy is appropriate for their individual medical condition and overall health status. Patients with certain medical concerns may need to be monitored closely during EECP therapy to ensure safety and efficacy.