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What You Need to Know About External Counterpulsation (ECP) Therapy

Updated: Mar 26

What is external counterpulsation (ECP)?

It is a natural and non-invasive or non-surgical outpatient treatment for patients suffering from poor circulation and heart-related symptoms.

ECP treatment is approved by the Malaysian Medical Device Authority of the Health Ministry (MMDA) or Ministry of Health Malaysia (MOH) as well as the US Food and Drug Administration (FDA).

Why must I use ECP therapy?

ECP treatment is an alternative method to improve your heart circulation and reduce the risk for chest pain especially If you are suffering from severe angina or are unable to undergo surgery (bypass surgery).

ECP Treatment Comparison (Pulmonary Artery)

  • ECP has the potential to open up small pre-existing capillaries which are in normal circumstances collapsed when not in use.

  •  These opened up channels or collaterals may eventually become a “natural bypass” vessel that provide blood flow to heart muscle, which can relieve angina symptoms.

How Does ECP Work?

What is the External Counter pulsation Procedure?

Here are the procedures for ECP:

  • During ECP session, a series of blood pressure-like cuffs wrapped around the patient’s calves, thighs, and buttocks, are inflated & deflated at regular intervals.

  • The inflation phase occurs when the heart is in diastole (at rest), and the deflation phase occurs when the heart is in systole (when pumping).

  • During the diastolic phase, this mechanism forces blood from the lower limbs to the heart, greatly improving circulation.

What are the advantages of ECP Treatment? ECP treatment enhances the complete health system by re-establishing the flow of oxygenated blood to the heart and all other regions of the body. According to clinical research, ECP therapy helps more than 75% of patients, with improvements continuing 3 years after treatment. ECP treatment may,

  • Boost energy levels and physical endurance.

  • Reduce the use of drugs and nitroglycerin.

  • Reduce or eliminate chest pain symptoms

  • Reduce the signs of weariness and shortness of breath.

  • Improves the symptoms of heart failure

  • Reduce vascular disease-related leg pain.

  • Increase in coronary perfusion

  • Opens up collapsed pre-existing capillaries

  • Boost blood flow and organ perfusion.

  • Improved men's sexual effectiveness (no more erectile dysfunction)

  • Increase in oxygen consumption

  • Reduce Parkinson's disease symptoms.

  • Reduce the symptoms of Alzheimer's disease.

  • Reduce the number of visits to the emergency room and hospitalizations.

  • Good for anti-aging

Who is eligible for ECP treatment?

  • Chest pain (angina)

  • SOB (Short of Breath)

  • Fatigue

  • Poor Sleep

  • Erectile Dysfunction (ED)

  • Chronic Kidney Disease

  • Stabilize Blood Pressure

  • The requirements for invasive operations like surgery are not met.

  • Still experiencing heart symptoms after an invasive procedure such as an angioplasty, stenting, or bypass surgery

If you have any of the following symptoms, ECP treatment is not for you:

  • Pregnant Women

  • Blood clots in leg (deep vein thrombosis)

  • Enlarged Heart (Cardiomegaly)

  • Rapid Heartbeat (Tachycardia)

  • Heart Fibrillation

  • Abnormal Heartbeat

  • Pulmonary hypertension (PH)

  • Congenital Cardiac

  • Aortic Dysfunction

  • Brain Hemorrhage

  • hypertension (high blood pressure)

  • Heart valve abnormality

  • Severe vascular illness

  • Any kind of heart block (with or without pacemaker)

What is the recovery time from ECP?

ECP treatment doesn’t require a hospital stay.

No hospitalization. No Pain. No Surgery.

You can go home immediately after the treatment.

ECP Treatment Results: According to the clinical evidence, the data shows 75%–80% effectiveness of ECP treatment, which can sustain up to 3–5 years after the post-treatment period. The results shown are:

  • Patients who receive ECP treatment frequently have reduced or no angina.

  • After receiving ECP treatment, 80% of patients report improved health conditions.

  • People frequently reduce their angina medications.

ECP Treatment Testimonials:

We have hundreds of testimonials from our patients; below are some of them:


"Normally I can walk only 3000 steps daily, but now I can walk 10,000 steps a day after 3 sessions of ECP treatment." Amazing!

Patient: Mr. Teo

Age: 61-year-old

Illnesses: Bypass surgery and stroke.


"After 15 sessions of ECP, I feel a lot different now." I can jog even further. "The pulse rate and my blood pressure have substantially improved, and without the side effects of western medication."

Patient: Mr. Foo Ho

Age: 51 years

illnesses: heart failure


"Saya mempunyai masalah kelakian akibat jantung saya yang tersumbat."

Patient: Mr. Shahabudin

Age: 57 years

Illness: Clogged Heart Arteries

How much does ECP treatment cost in Malaysia?

On average, the standard cost for ECP treatment is RM500 per sessions in 1 hour.

For the best result, the patient needs to attend 35 sessions.

Good news!

Do you want the ECP treatment trial offer?

1 hour doctor consultation, an ECP trial session, a microcirculation test, and ECG


External counterpulsation (ECP) treatment provides a secure and reliable alternative to surgery in treating angina (chest pain) and patients with coronary artery disease.

ECP works by applying pressure to your lower legs with inflated cuffs.

In order to enhance blood flow and cardiac function, the pressure is timed to your heartbeat.

ECP is becoming more widely accessible in Malaysia.

It is also a relatively inexpensive form of treatment.

FAQ about ECP treatment:

1. Is ECP better than angioplasty or bypass?

For individuals who have already undergone angioplasty or bypass surgery and wish to prevent further procedures, ECP has shown a remarkable result. The International Registry of ECP Patients did a study with 5022 patients in 92 centres and found that 5-year survival rates of:

  • ECP patients, 88%

  • Heart medication patients, 78%

  • Angioplasty or Bypass Patients, 86%–89%

2. Can ECP treatment prevent heart attacks?

According to Kementerian Kesihatan Malaysia (KKM), "On average, 20% to 25% of people will die because of a heart attack in Malaysia if they do not get treatment early."

Patients who were undergoing treatment for 35 sessions or experiencing heart attack symptoms were shown to benefit from ECP treatment by 80%.

It opens up pre-existing capillaries in heart, enhancing collateral vessels blood flow to heart muscles.

3. Can ECP be used to treat or remove a blockage?

Patients with a blockage severity of 70–80% or 100% are eligible for ECP. The severity of the blockage is not a contraindication for ECP. ECP can improve blood supply to the heart muscle by opening collateral arteries, regardless of obstruction level.

4. How long does ECP treatment take?

To get the best result, the patient must attend 35 sessions. One session is for one hour a 


5. Can ECP reduce the blood pressure?

Yes. In long term, ECP can reduce long standing hypertension, by reducing peripheral vascular resistance.

6. Is ECP covered by insurance?

No. It is not covered by insurance however ECP is approved by the FDA for chronic stable angina, cardiogenic shock, congestive heart failure, and during a heart attack.

ECP saves lives and is considerably cheaper and safer than traditional invasive procedures such as angioplasty and coronary stents.

7. What is the recovery time from ECP?

ECP treatment doesn’t require a hospital stay. No hospitalization. No Pain. No Surgery. You can go home immediately after the treatment.

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