External Counterpulsation (ECP) an effective form of treatment for angina is still finding itself on a back stage and this effective procedure is still to fall into the mainstream of cardiology practice. For long interventional cardiologists have been avoiding this safe, non-invasive treatment like a plague, but changes in approach to this procedure are lately being noticed.

For more than a decade since ECP was taken up as a treatment method for life threatening disabilities due to CAD, CHF, and stable angina the world over, its effectiveness in treating these cardio-diseases is beyond doubt a success and is well documented in the text book of cardiology and various cardiology journals.

 Years ago a randomized trial with ECP, published in the Journal of the American College of Cardiology  (1999), showed that ECP significantly improved both the symptoms of angina  and exercise tolerance  in patients with coronary artery disease. ECP also significantly improved "quality of life" measures, as compared to placebo therapy.

In one of the issue of Cardiology, investigators report that ECP works even better in patients who have not yet had invasive treatment for angina. Among patients participating in the International ECP Patient Registry who received ECP as first-line therapy (instead of receiving it only after other treatments failed,) 89% experienced an immediate improvement in angina, and 84% reported that the improvement persisted at 6 months. This compares to a 79% improvement rate with ECP among patients who had already received invasive treatments.