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Published on Mar 30, 2019
So when you talk about alternative we are implying replacing the bypass surgery and angioplasty by a simple EECP treatment solution. I think rather it's not that simple. First, you should understand how the disease ( coronary artery disease) is present or classified. So there are two ways the disease can present and based upon that we can know Whether EECP is an absolute alternative for your clinical condition. The disease present as two extreme conditions, one is stable and the other is unstable.
In the first condition stable, the patient is presented in out-patient treatment or in a health check-up. where the patient usually undergo a TMT ( treadmill ) or ECG ( Electrocardiography) or, ECHO ( echocardiography) and they identify to have heart disease. A coronary angiogram is done later to show that they have heart disease or coronary artery blockage. The stable patients many times walk into a physicians clinic complaining of occasional chest discomfort, which is present for a couple of months or occasionally it started getting worse and then the physician do various investigations and drug therapy. Here you have to be very clear, what you have is a stable heart condition or we call it as chronic stable angina. So in a stable patient, all the investigation, drug therapy, and diagnosis of heart disease due to coronary vessel blockage all are done completely as an out-patient basis.
In the second presentation, which is unstable is when you been taken to the hospital and got admitted and there the physician diagnose that you have an Acute coronary syndrome or myocardial infarction (Heart Attack). So now you understand the two extreme opposite conditions. One is acute coronary syndrome ( Unstable ) and second is chronic stable angina ( Stable).
In a patient with chronic stable angina I would say EECP can completely replace a CABG (Bypass surgery), Angioplasty because you are a stable patient and even if you are referred to undergo bypass surgery and angioplasty you might not have any benefits to reduce your heart attack or prolong your survival or to protect you against future hospitalization or a stroke through this procedures. In this condition having as a non-invasive, safe EECP would be the best option rather than bypass surgery or angioplasty.
But again still bypass surgery and angioplasty is must in other condition what I mentioned as an acute coronary syndrome where you get hospitalization. Here within hours if you are able to take an angioplasty you are not only improving your quality life but also improving your survival, prevent you to getting another heart attack or prevent you to getting a stroke or any other vascular event. Also if your surgeon decided to do bypass surgery for all the obstructed vessels based upon your coronary anatomy and then it could be a life-saving. So now I have defined you about the acute condition, where bypass surgery and angioplasty play a role to improve not only your quality of life and also to protect against future cardiovascular events like heart attack. But the first condition where it is stable I would not think and no clinical data is currently available to support the idea that bypass surgery or angioplasty would ever have anything to protect your heart. It is only provided to improve your quality of life. So in that condition of stable angina, I would certainly consider EECP as an effective alternative to improve your quality of life and keep you back in your regular routine activity.