Your heart rests between beats. EECP fills that gap.
The heart has two phases: systole (contraction, when it pumps blood out) and diastole (relaxation, when it refills). During diastole, the coronary arteries — the vessels that supply the heart muscle itself — receive most of their blood flow.
EECP uses a series of pneumatic cuffs wrapped around your calves, thighs, and hips. These cuffs inflate rapidly at the precise moment your heart begins to relax — timed to your ECG — and deflate just as the next heartbeat begins. The effect is a surge of blood returning to the heart during diastole, increasing coronary perfusion pressure by up to 80%.
Done once, it's a hemodynamic event. Done 35 times over seven weeks, it's a biological remodeling — the body responds by growing new collateral vessels, improving endothelial function, and reducing the inflammatory markers associated with vascular disease.
Increase in coronary perfusion pressure during diastole. That's the mechanism — more blood to the heart muscle during the window when it's most receptive.
After 35 hours of treatment, the body has experienced 35 sustained diastolic augmentation events. The endothelium responds by upregulating nitric oxide production, promoting collateral vessel growth, and reducing systemic vascular resistance — effects that persist for 12 to 18 months after the course ends.
ECG monitoring begins
Three electrode leads track your heart rhythm in real time throughout the session. The system identifies the precise onset of diastole for every single beat.
Cuffs inflate at diastole
Cuffs around your calves, thighs, and hips inflate sequentially from distal to proximal — pushing blood back toward the heart at the exact moment it can receive it most effectively.
Coronary perfusion increases
The retrograde wave of blood increases diastolic pressure in the aorta, driving more blood into the coronary arteries during the window when they're most open.
Cuffs deflate before systole
Just before the next heartbeat, all cuffs deflate simultaneously — creating a sudden drop in peripheral resistance that reduces the heart's workload during contraction.
The treatment doesn't just work during the session. It trains the body to work differently afterward.
Hemodynamic adaptation
Patients typically notice nothing dramatic in the first week. The body is adapting to the augmentation pattern. Some patients report mild fatigue. A few notice improved sleep from the first session.
Endothelial response
Nitric oxide production increases. Endothelial function improves measurably. Many patients begin to notice reduced angina frequency, improved exercise tolerance, or better energy. This is the window where most patients first believe it's working.
Collateral development
The body has now had enough sustained stimulus to begin building new collateral vessels — the biological bypass that EECP is most famous for. Patients completing this phase show the most durable long-term outcomes.
Peak benefit window
Outcomes continue to improve after the course ends. The 3-to-6-month mark is typically when patients report their best functional status — lower angina burden, better exercise capacity, improved quality of life.
Durability
Most patients maintain significant benefit for 12 to 18 months. Some patients choose to do a second course at the 12-month mark to sustain and extend the gains.
Maintenance protocols
Some patients — particularly those with progressive conditions or who want to continue optimizing — do periodic maintenance sessions. We support this and can structure a maintenance program around your situation.
The only portable EECP system designed to go where patients are.
We treat exclusively on the Renew NCP-5. It's the machine that makes our in-home model possible — and it carries a set of FDA clearances that no other ECP system in the U.S. holds.
Chronic Stable Angina
The original and most well-known clearance. EECP is the only non-invasive therapy FDA-cleared for chronic stable angina. Medicare covers it under NCD 20.20.
Ischemic Heart Failure
Cleared for patients with reduced ejection fraction and exercise intolerance. The PEECH trial established the clinical basis for this indication.
Healthy Patients — VO₂ Max & Vasodilation
This is the clearance that sets the NCP-5 apart. No other ECP system in the U.S. is cleared to improve VO₂ max, vasodilation, and blood flow in healthy individuals. This is the clearance that makes EECP relevant for prevention, performance, and conditions like long COVID and dementia.
The NCP-5 was designed to travel.
Most EECP equipment is clinic-bound — heavy, large, and permanently installed. The NCP-5 is different. It was engineered to be portable from the ground up, which is what makes our in-home model clinically viable rather than a compromise.
Folds compact. Weighs under 200 pounds. Runs on a standard 120V household outlet. Fits in the back of a vehicle. Deploys in under 20 minutes.
| Manufacturer | Renew Group |
| Model | NCP-5 |
| FDA Status | Cleared — 3 indications |
| Power | Standard 120V outlet |
| Portability | Folds for transport |
| ECG Monitoring | 3-lead, real-time |
| Cuff Zones | Calves, thighs, hips |
| Session Duration | 1 hour |
EECP is non-invasive. But it's not appropriate for everyone.
The therapy is safe for the vast majority of patients with cardiovascular disease. There are specific contraindications that require clinical screening before treatment begins. We review all of these during the intake process.
If you have any of the conditions listed here, that doesn't automatically mean EECP isn't an option — it means we need to review your specific situation carefully before proceeding.
Absolute contraindications
- —Aortic insufficiency (moderate to severe)
- —Aortic aneurysm
- —Active deep vein thrombosis or phlebitis
- —Severe peripheral artery disease
- —Active bleeding or bleeding disorder
- —Pregnancy
Relative contraindications (reviewed case-by-case)
- —Uncontrolled hypertension
- —Significant arrhythmia
- —Decompensated heart failure
- —Recent cardiac catheterization (within 2 weeks)
- —Leg wounds or skin breakdown in cuff areas
Jack Clifford's definitive patient guide — the science, the history, the politics, and the practical reality of EECP. The book I wish I'd had in that hospital bed.