ENHANCED EXTERNAL COUNTERPULSATION (ECP) 
EECP therapy is a non-invasive outpatient treatment for coronary artery disease patients with angina pectoris refractory to standard medical therapy or surgical intervention. Following successful trials, Medicare coverage for this treatment modality has been granted. In simplest terms, EECP involves sequential inflation and deflation of compressive cuffs wrapped around the patient’s legs. These events are timed to the cardiac cycle and provide both an increase in the blood flow to the coronary arteries (inflation when heart is relaxed) and a reduction in the workload to the heart (deflation at the beginning of the ventricular contraction). In addition to improving the performance of the heart, it is possible that EECP may promote the development of collateral blood vessels (“natural bypasses”). The MUST-EECP trial reported that 1-hour sessions once or twice daily for total of 35 hrs (course of therapy 7 weeks, if used 1 hour/day Mon-Fri) decrease the frequency of angina and nitroglycerin usage. Some patients do not qualify for EECP such as those with valvular heart disease, recent heart attack or bypass surgery, deep vein thrombosis, severe PVD, bleeding problems, certain cardiac arrhythmias, pregnant women among others.