Figure 1.

Technique of enhanced external counterpulsation (EECP): three pairs of pneumatic cuffs are applied to the calves, lower thighs, and upper thighs. The cuffs are inflated sequentially during diastole, calves up. The pressure is released at the onset of systole. The compression of the lower extremity venous bed increases venous return and increases diastolic pressure. Inflation and deflation are timed according to the R wave on the patient’s cardiac monitor. The pressures applied and the inflation–deflation timing can be altered by using the pressure waveforms and ECG on the EECP monitor.