External Counter Pulsation



What is External Counter Pulsation?

External Counter Pulsation (ECP) is performed as a non-invasive treatment to lower the number and intensity of angina episodes. Treatment is administered through three pairs of external inflatable cuffs that are applied around the lower legs, upper legs and buttocks.



How ECP Performed?

  • The patient's systole and diastole of the heart is measured by placing ECG stickers on the patient's chest.
  • The patient is required to lie down on a bed.
  • The patient's calved, thighs and buttocks are wrapped around with blood pressure cuffs.
  • When the heart relaxes at the precise time of diastolic, the cuffs start inflating from the calves, moving upwards to the buttocks. This leads to a counter pulsation of the blood
  • When the heart contracts, the cuffs quickly deflate and relax. The sensation may feel like a firm massage


How ECP Increased Blood Flow?

  • Dilating blood vessels - small blood vessels enlarge
  • Opening dormant blood vessels lying closed since birth
  • Angiogenesis - forming new blood vessels (collaterals)











Who Should Not Have ECP?

  • If you have a pacemaker or implanted cardioverter defibrillator (ICD) or are taking blood thinners (such as heparin or warfarin), you may not be eligible for ECP.
  • Severe heart failure.
  • Serious heart valve problems.
  • Heart rhythm problems (arrhythmias)
  • High blood pressure that is not controlled with medication.
  • Peripheral artery disease or peripheral vascular disorders (blockages in the arteries or vein of the legs)
  • Tendency to bleed excessively (including people with ulcers)
  • Pregnant women.

Who is Eligible for ECP Treatment?

  • Individual who had coronary artery bypass (CABG) or stents placed in the coronary arteries with ongoing angina.
  • Had no prior bypass or stenting but continue to suffer from angina.
  • For well-being.


Treatment Location

Az-Zahrah Women Wellness Centre
No 36-G-1, Medan PB1
Seksyen 9, 43650 Bandar Baru Bangi,
Selangor Darul Ehsan.
Tel : 03-8921 2626
Email : wellness@azzahrah.my

















Benefits of ECP Treatment

  • Increase in Energy & Exercise tolerance.
  • Increase alertness (brain function).
  • Reduce or eliminate symptoms of chest pain.
  • Reduce symptoms of fatigue.
  • Reduce symptoms of Shortness of Breath.
  • Reduce heart palpitation.
  • Reduce leg pains from peripheral vascular disease.
  • Strengthen the heart muscle by reviving parts of the heart that have hibernated from lack of blood flow.
  • Increase in perfusion creates natural bypasses around narrowed arteries in heart as well as other organs such as the lungs, kidneys, liver & the brain.
  • Sustainable relief of symptoms related to Ishemic Heart disease.
  • Sustainable Increase in Coronary Perfusion.
  • Improvement in sexual function for men.
  • Reduce symptoms of Parkinson's Disease.
  • Reduce symptoms of Dementia (Alzheimer Disease).
  • Reduce blood pressure.
  • Decrease workload of the heart.
  • Retrograde Arterial Flow (Shear Stress) increase endothelial function.
  • Peripheral Training effects (similiar to exercise).
  • Cardiac Re-modelling (stunned & hibernated myocardium).
  • Promotion of collateralization
  • Improvement in oxygen consumption (VO2).
  • Regression of atherosclerosis.
  • Improvement in ventricular function.
  • Increase in Cardiac Output.
  • Decrease in Cardiac Workload.
  • Release in growth factors.
  • Reduction in Angina & Heart failure symptoms & Classifications.
  • Decrease Medication (including Nitroglycerin & Ranexa).