Enhanced External Counterpulsation in the Treatment and Rehabilitation of Coronary Patients in Indonesia

Authors:
  • SKSjukri Karim
    Sjukri Karim
  • ASAulia Sani
    Aulia Sani
  • SKSantoso Karo-Karo
    Santoso Karo-Karo
  • MKManoefris Kasim
    Manoefris Kasim
  • ABAdnil Basha
    Adnil Basha
  • IGIgn Gunadhi
    Ign Gunadhi
  • WJWillie Japaries
    Willie Japaries
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Abstract
We report our experience using the new noninvasive treatment for coronary patients called enhanced external counterpulsation (EECP). Thallium-201 stress scintigraphy and treadmill test were done before and after 36 sessions of EECP treatment on 38 coronary patients. The results showed significant (P < 0.01) improvement in perfusion as well as exercise tolerance in 86.8% and 94.2% of patients, respectively. The symptoms of angina pectoris and functional classes of the patients also showed significant (P < 0.05) improvement. All patients tolerated the treatment without serious complications. The magnitude and rate of increased exercise tolerance achieved by EECP treatment was greater than those achieved by training after coronary bypass surgery (CABG) or exercise training rehabilitation program for the matched coronary patients reported by others 7 , 8 . The mean double products (DP) from the treadmill test results of the improved Tl-201 perfusion subgroups decreased significantly (P < 0.001). On the contrary, the DP of the unimproved subgroup increased significantly (P < 0.001). This could mean improvement in efficiency of the heart in the former, that is, more work was done with lower pressure-pulse products.