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To: JoeinIowa who wrote (870)	1/5/2003 9:03:56 PM
From: JoeinIowa	Respond to of 23958

Recent article on Vasomedical and EECP. Heart patient finds 'being pressured' can be good therapy for angina attacks By HENRY L. DAVIS News Medical Reporter 1/3/2003 HARRY SCULL JR./Buffalo News After six months of the new treatment, Alvin Janes can walk around the block without discomfort. Alvin Janes used to pop a dozen nitroglycerin pills a day to relieve his angina, a terrifying pain in the chest caused by the heart not getting enough blood. He couldn't even walk from the television to the bathroom without reaching for the drug. So, when his cardiologist suggested a therapy new to the Buffalo area and unfamiliar to most people, the desperate Janes jumped at the opportunity even if the treatment seemed a little odd. For 35 sessions - an hour each, five days a week - Janes lay on a bed while pressure cuffs - wrapped tightly around his calves and upper and lower thighs - were inflated in sequence with his heartbeat. Janes watched "The Price Is Right" on television or dozed off during the painless treatments. Now, a few months later, he is a changed man. He goes almost a week without taking medication and can walk around the block without discomfort. "By the sixth session, I had more energy," said Janes, 70, a former railroad conductor for Conrail who lives in West Seneca. "It has given me a little more time." The treatment, called enhanced external counterpulsation, or EECP, is a non-invasive technique to improve heart functioning. It squeezes blood up from the legs when the heart is resting between beats and stops squeezing when the heart beats again. Why the technique works is not completely clear. Studies suggest the treatment might promote the growth of new blood vessels in the heart and improve blood flow to areas that are not getting enough blood and oxygen. This improved blood flow decreases chest pain. The treatment is an old idea, but federal Food and Drug Administration approved the treatment only seven years ago to treat patients in the United States for chronic angina. The agency also approved the technique for congestive heart failure also. Enhanced External Counterpulsation is not for everyone and is not a first option for patients in a medical crisis, experts say. Individuals with chest pain caused by coronary artery disease are likely to benefit the most. Nearly 13 million Americans suffer from coronary artery disease, according to the American Heart Association. It is the most common form of heart disease, often leading to a heart attack, and is caused by a narrowing of the arteries that feed the heart. This technique also is suited for patients whose artery blockages can't be opened with angioplasty or bypass surgery. For patients like Janes, who have undergone multiple procedures and for whom additional surgery carries excessive risk, the procedure may be the only way to obtain relief from angina. "The great thing about it is that it's completely external. There's zero mortality," said Aaron Hirsch, a pharmacist who opened Vascuflo in the Northwoods Medical Center in Amherst, the first facility in this region to offer the therapy. The treatment has evolved from a principle described in 1953 by Harvard University researchers about how the heart uses oxygen differently, depending on whether it is resting or working. In the 1960s, other Harvard researchers developed a device for external counterpulsation. Although the technique showed promise, it was overshadowed by the emergence of heart bypass surgery and angioplasty. While physicians in the United States turned their attention to the invasive treatments, physicians in China adopted and refined external counterpulsation. More than 600 devices are in use in the United States, according to Vasomedical of Westbury, N.Y., one of the leading manufacturers of external counterpulsation equipment. Hirsch bought the Vasomedical system for $220,000 after he watched his father receive the treatment in Rochester. "I couldn't understand why we didn't have EECP here," he said. His facility has seen seven patients since opening last year. Medicare covers the treatment, which is less expensive than heart surgery - $5,000 to $7,000 versus $50,000 to $60,000 - but only for angina patients who are not good candidates for a procedure. Some health insurance plans formally cover the therapy. Others have been approving the treatment on a case-by-case basis. How long the benefits of Enhanced External Counterpulsation last and if a second round of treatment is as effective remain unknown. "We've got seven years of experience in this country, and, so far, it looks good," Hirsch said.