Chronic Stable Angina
Patients with documented coronary artery disease and chronic stable angina who continue to experience symptoms despite guideline-directed medical therapy.
Indications & Suitability
Patient Selection
EECP is considered for selected cardiovascular patients where the clinical indication is appropriate, contraindications have been considered by the treating/referring doctor, and the therapy complements the patient's existing cardiology management plan.
EECP is generally most relevant for clinically stable patients who remain symptomatic or functionally limited despite guideline-directed medical therapy, particularly where further revascularisation is not indicated, not feasible, or carries unfavourable risk.
Patient Groups Commonly Considered for EECP
Refractory Angina Despite Optimal Medical Therapy
Patients with persistent angina despite maximally tolerated medical therapy, including those in whom further PCI or CABG is not feasible, not indicated, or assessed as carrying unacceptable individual risk.
Diffuse or Complex Coronary Artery Disease
Patients with diffuse atherosclerosis, small-vessel disease or coronary anatomy not suitable for further revascularisation.
Persistent Symptoms Post-PCI or Post-CABG
Patients with ongoing angina or ischaemic symptoms following previous revascularisation, where further intervention has been clinically reviewed.
Reduced Exercise Tolerance or Functional Limitation
Patients with limited exercise tolerance or reduced functional capacity attributable to ischaemic heart disease despite guideline-directed medical therapy.
Limited Participation in Cardiac Rehabilitation
Patients who are unable to progress cardiac rehabilitation due to angina, exertional symptoms or reduced functional capacity.
Microvascular Angina / INOCA
Patients with suspected or confirmed microvascular angina or ischaemia with non-obstructive coronary arteries, where symptoms remain clinically significant and other causes have been considered.
Medication Intolerance or Limited Anti-Anginal Options
Patients in whom anti-anginal therapy is limited by hypotension, bradycardia, adverse effects, drug interactions or other clinical constraints.
Selected Heart Failure Patients
Patients with stable heart failure and reduced functional capacity, where EECP is considered clinically appropriate by the treating/referring doctor as part of the broader management plan.
Final Suitability
Final suitability should be determined in collaboration with the treating/referring doctor. Vasoflo reviews referral information to confirm that the indication is appropriate and that relevant safety considerations have been addressed before treatment commences. Patients who have requested assessment for EECP may also be reviewed, provided the referral is supported by the treating or referring doctor and considered within the patient's overall cardiac management plan.
EECP is intended as an adjunct to — not a replacement for — guideline-directed medical therapy, cardiac rehabilitation, PCI, CABG or specialist cardiology care where clinically indicated.
Contraindications and Precautions
Clinical screening for EECP suitability should be completed by the treating or referring doctor before referral. Vasoflo does not independently diagnose, investigate or medically clear patients; it reviews the referral information to confirm that relevant contraindications and safety considerations have been addressed, and contacts the referring doctor for clarification where any concerns or uncertainties are identified. The following contraindications and precautions are commonly recognised in relation to EECP, and assessment of these factors remains the responsibility of the treating or referring doctor.
| Category | Examples |
|---|---|
| Acute coronary syndromes | Unstable angina, recent acute coronary syndrome, or recent myocardial infarction. |
| Heart failure | Acute or decompensated heart failure, uncontrolled volume overload, or patients at high risk from increased venous return. |
| Valvular disease | Clinically significant valvular disease, particularly moderate-to-severe aortic regurgitation, severe aortic stenosis or other valve disease where diastolic augmentation or increased venous return may be poorly tolerated. |
| Rhythm / device triggering | Uncontrolled arrhythmias, heart rates outside a range suitable for EECP triggering, or pacemaker/device settings that interfere with inflation and deflation timing. |
| Vascular / thromboembolic | Severe peripheral arterial disease, severe lower-limb vaso-occlusive disease, active or recent DVT, thrombophlebitis, pulmonary embolism, clinically significant aortic aneurysm, or vasculitis affecting the extremities. |
| Haematological / bleeding risk | Active bleeding, significant bleeding disorder, coagulopathy, or anticoagulation outside the treating doctor's acceptable therapeutic range. |
| Blood pressure | Severe uncontrolled hypertension, commonly referenced as ≥180 mmHg systolic or ≥110 mmHg diastolic. |
| Respiratory | Severe chronic lung disease or pulmonary hypertension where increased venous return or treatment positioning may be poorly tolerated. |
| Recent procedures / trauma | Recent major surgery, recent cardiac catheterisation or femoral arterial puncture, recent lower-limb surgery, trauma or fracture. |
| Local cuff application issues | Burns, open wounds, active infection, significant skin breakdown or other conditions affecting safe cuff placement. |
| Other | Pregnancy or any other condition the treating/referring doctor considers relevant to EECP suitability. |
What Happens if a Patient Is Not Suitable
If the referral information indicates that EECP may not be appropriate, or if potential contraindications or safety concerns are identified, Vasoflo will seek clarification from the referring doctor before treatment proceeds.
Where EECP is determined by the treating/referring doctor to be unsuitable, the patient remains under their ongoing care. Vasoflo does not recommend alternative therapies, alter medications or provide cardiac management outside the referral context.
Working With the Treating Cardiologist
Vasoflo's role is to deliver the EECP treatment course in accordance with the referral and agreed treatment plan.
The treating cardiologist or referring doctor remains responsible for the patient's overall cardiac management, including clinical assessment, suitability determination, medication changes, follow-up investigations, ongoing surveillance and longer-term care.
Vasoflo will contact the referring doctor if clarification is required before or during the treatment course.
Refer a patient for assessment
Secure referral form for treating doctors.