by EBSCO Medical Review Board


Enhanced external counterpulsation (EECP) uses inflated cuffs on the legs to help push blood back to the heart. It improves blood flow and decreases the workload of the heart.

The Cardiovascular System
EECP pushes blood back toward the heart to reduce the heart's workload.
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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 ease pain. It 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

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


You will not be given any anesthesia. EECP is not painful.

Description of Procedure

You will lie on a padded table. Electrodes will be placed on your chest to watch your heart rhythm. Your blood pressure will also be checked.

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

How Long Will It Take?

You will be treated for a total of 35 hours. It will be spread out over 7 weeks.

Will It Hurt?

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.

Call Your Doctor

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.


American Heart Association 

National Heart Lung and Blood Institute 


Canadian Cardiovascular Society 

Heart and Stroke Foundation of Canada 


Angina. National Heart Lung and Blood Institute website. Available at: Accessed October 20, 2020.

Angina (chest pain). American Heart and Stroke Association website. Available at: Accessed October 20, 2020.

Enhanced external counterpulsation (EECP). Cleveland Clinic website. Available at: Accessed October 20, 2020.

Revision Information