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Efficacy of external counterpulsation enhanced with outpatient cardiac rehabilitation

Abstract Enhanced external counterpulsation (EECP®) is useful in reducing angina pectoris and increasing functional capacity in patients with coronary artery disease. We sought to determine whether undergoing EECP with outpatient cardiac rehabilitation (OP-CR) would potentiate functional capacity and ventilatory threshold and decrease depression. A retrospective analysis was conducted on all (n = 91) patients undergoing EECP from 2001 to 2012. Those who underwent EECP only (n = 56) were compared with those who underwent EECP with OP-CR (n = 35). Patients underwent cardiopulmonary testing and completed the Patient Health Questionnaire (PHQ9) before starting and on completion of EECP. A general linear mixed model was used to compare the impact of adding OP-CR to EECP. Mean values, standard deviations and standard errors of the mean were calculated for each subgroup. Both groups significantly decreased PHQ9 and increased aerobic exercise performance and ventilatory threshold, but the EECP with OP-CR group increased ventilatory threshold (by 60.5%) and decreased PHQ9 (by 51%) significantly more than the EECP-only group. This study indicates that participation in EECP is beneficial, with benefits increased when patients undergo simultaneous OP-CR.