Contraindications

• Arrhythmias that interfere with machine triggering
• Bleeding diathesis
• Active thrombophlebitis
• Severe lower extremity vaso-occlusive disease
• Presence of a documented aortic aneurysm requiring surgical repair
• Pregnancy

Precautions

• Patients with blood pressure higher than 180/110 mmHg should be controlled prior to treatment with enhanced external counterpulsation.
• Patients with a heart rate of more than 120 bpm should be controlled prior to treatment with enhanced external counterpulsation.
• Patients at high risk of complications from increased venous return should be carefully chosen and monitored during treatment with enhanced external counterpulsation. Decreasing cardiac afterload by optimizing cuff inflation and deflation timing may help minimize increased cardiac filling pressures and the possibility of pulmonary congestions due to increased venous return.
• Patients with clinical significant valvular disease should be carefully chosen and monitored during treatment with enhanced external counterpulsation. Certain valve conditions, such as significant aortic insufficiency or sever mitral or aortic stenosis, may prevent the patient from obtaining benefit from diastolic augmentation and reduced cardiac afterload in the presence of increased venous return.