Patients with severely compromised cardiac function appear to be more at risk for adverse clinical events with EECP treatment, but rates of occurrence are within expectations for patients with these types and severity of illnesses indicated for treatment with EECP. Careful patient selection, thorough evaluation before and after each treatment, added vigilance in periprocedural monitoring (oximetry, hemodynamic, electrocardiographic), properly equipped facilities and appropriate medical supervision is recommended and can minimize the occurrence of adverse events.
- Congenital Heart Disease
- Aortic insufficiency enough to allow regurgitation
- Phlebitis and/or recent history of thromboembolus
- Pregnant women and women of childbearing potential who do not employ a reliable contraceptive method to avoid possible danger to fetus.
Precautions / Limitations:
- Arrhythmia that might interfere with the triggering of the EECP system, e.g. Atrial fibrillation, atrial flutter, ventricular tachycardia
- Bundle branch Block or Pacemaker that might interfere with the Triggering of the EECP system.
- Limiting peripheral vascular disease (PVD). Severe PVD with reduced vascular volume and diminished musculature of the lower extremities can compromise effective counterpulsation.
- Cardiac catheterization within 1 to 2 weeks to minimize the likelihood of bleeding at the femoral puncture site.
- Severe hypertension (>180/110mmHg). Under these circumstances, EECP could produce diastolic blood pressure levels surpassing acceptable limits.
- Bleeding diathesis, coumadin therapy with INR> 2.0 because the pressure of cuff inflations might cause bleeding in muscles of the leg.
- Significant pulmonary disease.
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