New Graduated Pressure Regimen for External Counterpulsation Reduces Mortality and Improves Outcomes in Congestive Heart Failure: A Report From the Cardiomedics External Counterpulsation Patient Registry

External counterpulsation (ECP) has been shown to increase exercise tolerance and reduce angina episodes, Canadian Cardiovascular Society Functional (CCSF) class, anginal medication usage, and hospitalizations in refractive CCSF class III and IV stable angina. However, the high pressures and resulting 1.5:1–2:1 peak diastolic to peak systolic pressure (D/S) ratios shown to be optimal in the treatment of angina can cause excessive preload and adverse effects in congestive heart failure (CHF) patients, particularly those with left ventricular ejection fractions