External Counterpulsation Therapy (ECP) is an exciting option for the treatment of heart disease, specifically Coronary Artery Disease. Many people who suffer from heart disease are unable to supply enough oxygen-rich blood to nourish the heart muscle (ischemia). The symptom commonly associated is angina (angina pectoris), or chest pain. Currently, many cardiologists prescribe ECP therapy for the treatment of angina. ECP has helped people throughout the world enjoy life again. It has given new hope to many of those suffering from heart disease. After completion of ECP therapy, many people return to an active and fulfilling lifestyle.

ECP therapy consists of 35 daily treatments lasting for one hour per day. ECP is administered on an outpatient basis and requires no hospitalization. Best of all, ECP is an exciting option for those people who have had, or are not good candidates for bypass surgery or angioplasty. If medication does not provide adequate relief from angina, ECP could be a positive alternative to invasive procedures.

What are the Benefits of ECP Therapy?

ECP therapy is a pain-less treatment that helps alleviate symptoms of angina by increasing blood flow to the coronary arteries and heart muscle. This therapy does not remove blockages or stop the disease process. However, ECP helps revascularize the heart muscle through the development of collateral vessels. Collateral vessels help to increase blood supply to the heart muscle. Clinical Studies have shown:

  • ECP provides relief from Angina (chest pain)
  • ECP may decrease need or use of medication
  • ECP helps to improve exercise tolerance and daily activities
  • ECP improves overall quality of life
  • ECP provides results that can last for years

How does the Process of ECP therapy work?

During ECP therapy, pressure cuffs are wrapped firmly around the calves, thighs, and buttocks. The cuffs inflate and deflate between each heart beat. When inflated, the cuffs squeeze blood toward the heart increasing coronary perfusion pressure, coronary blood flow and oxygen supply. This process helps oxygenated blood reach the heart muscle, further reducing or eliminating angina pain.

Do Medicare and other insurance companies pay for ECP therapy?

Yes. Medicare will pay for ECP treatment when it is prescribed by a cardiologist. Many private insurance companies are also paying for ECP therapy.  Check with your insurance provider to determine if ECP therapy is a covered treatment.

Is ECP therapy an appropriate treatment option?

Consult with your cardiologist or referring physician to determine if ECP therapy is an appropriate procedure for you. ECP therapy may be appropriate if you answer “yes” to one or more of the following questions:

  • Do you experience frequent chest pain with (or without) physical exertion?
  • Does your chest pain stop you from performing daily activities?
  • Do you become short of breath with regular activity?
  • Do you suffer from Ischemic Congestive Heart Failure (CHF)?
  • Are you anxious about the possibility of undergoing bypass surgery or angioplasty?

How can I find a local cardiologist who offers ECP therapy?

Physicians throughout the United States and Canada offer ECP therapy. Contact your cardiologist or referring physician to find out where ECP is provided in your area.

ECP Therapy Training

ACSD has created a complete and comprehensive External Counterpulsation (ECP) therapy training program. This inclusive program not only teaches technicians the history and clinical benefits of ECP therapy, it trains technicians how to optimize the therapy delivered. We dedicate multiple days on-site to train your staff. This ensures that technicians are confident and properly administer patient care.

We whole heartedly believe that practice makes perfect.  During the course of our training program our staff reviews procedures and protocols, including how to generate a clinically relevant ECP report.

Along with training from an experienced Education department member, customers receive a variety of support materials. This ranges from Training and Operational Manuals to Reimbursement Guides. ACSD does everything possible to assist customers in launching a successful ECP program.

ECP Training Fulfillment Program

The Education department also offers supplemental ECP training.  The ECP Training Fulfillment program has been designed to provide ongoing training and follow-up for interested users. Those meeting the program requirements receive ACS recognition for providing ECP therapy.



If you suffer regularly from the pains of angina, you are not alone. According to the American Heart Association, approximately 9,100,000 people in the United States also suffer from angina pectoris. Nearly 500,000 new cases will be diagnosed each year.1

Simply put, angina (pronounced an-jahy-nuh) is the symptom commonly known as chest pain. Angina can occur for different reasons, many of which are related to heart disease.

There are two classifications for angina pectoris: Stable angina and unstable angina. Stable angina is the most common type of angina and tends to occur on a frequent basis. Stable angina is often predictable and occurs with physical activity, such as walking or climbing stairs. Stable angina tends to go away with rest or medication (nitroglycerin).

Unstable angina, on the other hand, is not as common but can be a more serious condition. Unstable angina causes severe, gripping chest pain that is often less predictable. This type of angina can occur with no physical activity (at rest). If you suspect that you may have unstable angina contact your doctor or even the hospital immediately. This could be a sign of a serious heart condition and could lead to a heart attack or stroke.

What Causes Angina?

The causes for angina are often heart related. One of the most common causes of angina is Coronary Artery Disease (CAD). Coronary Artery Disease is a condition in which the arteries that supply oxygen rich blood to your heart build up plaque over time. This progressive condition is known as atherosclerosis (pronounced ath-uh-roh-skluh-roh-sis).

Atherosclerosis is the leading cause of Coronary Artery Disease. As plaque accumulates over time, the arteries begin to narrow. Eventually, these blockages sreduce blood flow to the heart muscle, a condition known as ischemia. Ischemia simply means there is not enough oxygen supplied to the heart to keep up with the needs of this hard working muscle. The body may react to this reduced blood flow by causing angina or even a heart attack.

What does Angina typically feel like?

When people describe angina, they often use terms like “constricting,” “suffocating,” “crushing,” “tightness,” or “squeezing” in their chests. Sometimes this pain may also radiate to your shoulders, arms, neck, jaw, or back. Other severe symptoms may include: weakness, heavy sweating, nausea, indigestion, cramping, or shortness of breath.

It is important to remember that many people do not display any symptoms at all. This is known as “silent” ischemia. Often times, CAD is not diagnosed until a heart attack or heart failure occurs. Heart attacks occur when, overtime, an area of the heart muscle is unable to receive oxygen rich blood. This causes permanent damage to the heart muscle. A heart attack is serious should be treated immediately.

How Long Does Angina last?

Angina attacks tend to begin gradually and reach the maximum intensity within a few minutes, and then it dissipates. The pain usually lasts from 1 to 15 minutes. Non-anginal chest pain typically lasts less than 5 seconds or may last more than 20-30 minutes (unless experiencing a heart attack).2 These non-coronary causes of chest pain may cause sharp, stabbing or burning sensations that tend to come and go within a few seconds.

When does Angina Occur?

The pains of angina can come and go at any time. Many people say they experience discomfort during rest, when walking or climbing stairs, after a heavy meal, or under conditions of extreme stress or cold weather. If you experience chest pain or discomfort with daily activities or when you are resting, contact your doctor immediately. This could be a sign of a serious condition.

What treatments are available for Angina?

The treatments for angina can vary. It is first necessary to determine what is causing the angina. If it is a heart condition, such as Coronary Artery Disease, physicians often prescribe pharmacological agents, perform bypass surgery (CABG), angioplasty or stenting when necessary and appropriate. ECP therapy is often prescribed for those unable or unwilling to undergo surgical intervention. Physicians commonly suggest lifestyle changes such as exercise, stress reduction, or diet modifications to help fight heart disease.


1 “Heart Attack and Angina Statistics.” American Heart Association. 15 Oct 2008.

Heart Attack and Angina Statistics

2 Rutherford, John D., M.D., Eugene Braunwald, M.D. and Peter Cohn, M.D. “Chronic Ischemic Heart Disease.” Ed. Braunwald, Eugene, M.D. Heart Disease – A Textbook of Cardiovascular Medicine. Philadelphia: W.B. Saunders Company, 1988. 1316-1318

Coronary Heart Disease


Millions of Americans are living with heart disease. The most common form of heart disease is Coronary Artery Disease, or CAD. In the United States, CAD is the leading cause of death for both men and women. According to recent trends, half of healthy 40 year old males and one in three healthy 40 year old females will develop CAD1.

What is Coronary Artery Disease?

Coronary Artery Disease is a condition in which the arteries that supply oxygen rich blood to your heart build up plaque over time. This plaque causes blockages to form in the arteries.  Eventually, this reduces the blood flow to the heart muscle, a condition known as ischemia. Ischemia simply means there is not enough oxygen supplied to the heart to keep up with the needs of this hard working muscle. The body may react to this reduced blood flow by causing angina or even a heart attack.

What is Angina?

Angina, or chest pain, may feel like pressure, tightness or squeezing in your chest. This discomfort may occur at rest, when walking or climbing stairs, after a heavy meal, or under conditions of extreme stress or cold weather. This pain may also radiate to your shoulders, arms, neck, jaw, or back.  If the blood flow to the heart is improved, it may be possible to reverse ischemia.

It is important to remember that many people do not display any symptoms at all. This is known as silent CAD. Often times, CAD is not diagnosed until a heart attack or heart failure occurs.  Heart attacks occur when, overtime, an area of the heart muscle is unable to receive oxygen rich blood.  This causes permanent damage to the heart muscle. A heart attack is serious should be treated immediately.

What Happens if CAD Remains Untreated?

If left untreated, Coronary Artery Disease can weaken the heart muscle and lead to arrhythmias, heart failure, or a heart attack. Arrhythmias are disturbances with your heart’s rhythm. Many arrhythmias can be treated and controlled with medication. Heart Failure is a condition in which the heart is unable to efficiently pump blood to your body.  A heart attack causes permanent damage to the heart muscle or even death.

Risk Factors for Coronary Artery Disease

There are many risk factors that may increase the likelihood of developing Coronary Artery Disease. Cholesterol levels, blood pressure, smoking, insulin resistance, diabetes, obesity, exercise, age and family history are all taken into account. Physicians base their diagnosis on the above factors as well as the results of diagnostic tests. These tests may include baseline electrocardiogram (EKG), exercise stress test, echocardiogram (ultrasound), and/or nuclear stress test.

Treatment for CAD

When it comes to your health always consider your options.  Understand what treatments are available. Together with your physician, assess what is the best option for you.

Treatments for CAD may include lifestyle changes such as exercise, stress reduction, or diet modifications. Physicians often prescribe pharmacological agents, or perform bypass surgery (CABG), angioplasty or stenting when necessary and appropriate. ECP therapy is often prescribed for those unable or unwilling to undergo surgical intervention. The goal of these treatments may be any of the following: relieving symptoms (chest pain, shortness of breath), reducing risk factors in an effort to stop plaque build up and eventually occlusions, lower the risk of clots, widen or bypass clogged arteries, form or grow collateral circulation, and/or prevent complications associated with CAD.

1 Rosamond w, Flegal K, Friday G, et al (February 2007). “Heart Disease and Stroke Statistics- 2007 Update: A Report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee.” Circulation 115(5): e69-171.

Detect and Treat

Since 1981, ACSD Remote Cardiac Monitoring products have been used to detect potentially life-threathening arrhythmias. Physicians and Research facilities have long relied on ACSD’s Ultra High Resolution TM to display clean ECG waveform tracings.  The high quality of this resolution provides a clear distinction in arrhythmias, and displays true pacer artifact to help determine pacer function.  Physicians trust ACSD Cardiac Monitoring products for a clear diagnosis.

In 2000, ACSD began the development of its External Counterpulsation (ECP) therapy device.  The latest product, the NCP Plus, is used globally to treat patients with refractory Coronary Artery Disease (CAD), specifically angina pectoris. For more information about ECP therapy for treating angina, click here.

Clinical Education

The Clinical Education department is proud to offer a wide variety of educational support programs.  Our department focuses on providing resources for those looking to enhance their clinical or product knowledge. It is our job is to provide a better understanding of the features and benefits of ACSD instrumentation.  Our professional staff has cardiac credentials and is committed to helping customers with educational support. Without a doubt, the Clinical Education department has heart!

Remote Assistance

ACSD Education members can train users remotely via the internet.  Instruction is provided utilizing the ACSD Online Training Program (OTP). With permission from the user, the Education Department can remotely access your product (ECP or Remote Cardiac Monitoring devices) using a high speed internet connection.

Training is both informative and interactive. It’s as if an Education Specialist is sitting next to you.  This can help provide users with clear clinical answers and additional training on product features.

Supplemental Educational Materials

The Education department strives to provide customers with an assortment of educational resources.  Users can rest assured that when your ACSD representative has left your facility, ample resources have been left behind. Step-by-Step Guides, Manuals, Posters, Patient and Physician brochures have all been created to assist customers in all of their Holter and ECP needs.

> Holter & Event Monitoring Clinical Support

> ECP Therapy Clinical Support

For further information about training, the Online Training Program (OTP), or supplemental material contact the ACSD Education Department.  Feel free to email the Education Department at info@acsd4u.com

External Counterpulsation


Lend your patients a helping hand with External Counterpulsation therapy.  External Counterpulsation, or ECP therapy, is a non-invasive treatment for patients with refractory coronary disease.  ECP therapy is commonly used to treat angina and anginal equivalent symptoms in patients not amenable to coronary catheterization or CABG.


ACS Diagnostics, Inc. the creator of the “Original ECP Treatment Report,” is proud of its latest advancement in ECP therapy. The NCP-Plus is the newest addition in ACSD’s trusted line of ECP therapy devices. The NCP-Plus offers a software program featuring the first ever comprehensive ECP therapy treatment report.  The “Original ECP Treatment Report” is a patented tool that can be used by physicians and staff to optimize patient outcomes through the proper administration of therapy.

The Multi-Tasking Unit

ECP Monitor
The NCP-Plus maintains a user-friendly interface while incorporating new, state-of-the-art technology. Only ACS offers a dual utility, convertible platform. Users now have the ability to launch other clinical applications while providing ECP therapy. This multi-tasking unit saves time and valuable office space.

For facilities with numerous beds, patients are no longer confined to one bed. The central database allows patients to be treated on any unit. Without sacrificing patient safety or care, one technician can now run multiple beds while performing other tasks. This ground breaking feature proves once again why ACSD is the trusted leader in ECP instrumentation.

The NCP-Plus Treatment Platform

The NCP-Plus features an improved treatment table and console design. The removable cut-out cushion and retractable hoses allows for a quick conversion to a multipurpose exam or echocardiography table. This is a great solution for space conservation and keeps your exam room active if it is not in use for therapy.

The aluminum constructed bed base provides better noise insulation and improved heat control, thus ensuring a comfortable environment for your patients. The NCP-Plus provides an adjustable head-of-bed control. This allows operators to adjust platform levels for patient comfort. This is a significant step for the treatment of Congestive Heart Failure patients or those who have difficulties laying flat.


ACSD provides interchangeable cuffs. These durable cuffs are available in four sizes – extra small, small, large, and extra large. This guarantees a custom cuff fit for patients. Optimal cuff size and fit is a key factor in providing effective therapy and improving patient comfort.

For further information about ACSD External Counterpulsation products and services, please contact an ACSD representative or email at sales@appliedcardiacsystems.com.

Heart Failure


Heart Failure is a serious condition that afflicts over 5 million people a year in the Unites States alone1. It is important to understand that Heart Failure does not mean the heart stops working. Heart Failure is actually a condition that develops overtime. Simply put, in patient’s who have Heart Failure their heart can not pump blood effectively. The pump is in a slump, so to speak.  Taking measures to prevent Coronary Artery Disease (CAD) is one way to help prevent Heart Failure. Diseases that damage the heart are the main cause of Heart Failure. These may include CAD, high blood pressure, and diabetes.

Understanding the Heart

First, let’s review the way the heart works.  This will help you better understand the way that Heart Failure affects the heart.

The heart muscle has four chambers. The two upper chambers are known as the atria. There is a right atrium and a left atrium. The two bottom chambers are known as the ventricles.  There is a right ventricle and a left ventricle.

Each of these chambers has a different job. The right atrium receives used blood from the body. As pressure builds up in the heart, the right atrium passes blood to the right ventricle. The right ventricle eventually pumps blood out to the lungs. The used blood is re-oxygenated in the lungs. As soon as this process occurs, oxygenated blood travels back to the left atrium. As the pressure builds, the left atrium passes blood to the left ventricle. The left ventricle is the biggest chamber, as it has the biggest job. It is responsible for pumping freshly oxygenated blood to all vital organs in the body.

Diagnosing Heart Failure

Heart Failure can affect both sides of the heart, or the right side alone. Right and left sided heart failure is the most common, and is referred to as left sided heart failure. Left sided heart failure is diagnosed when the heart can’t properly pump oxygen rich blood to the body.

When the heart can’t properly pump blood to the lungs, right side heart failure is diagnosed. This can be dangerous as fluid may build up in the feet, ankles, legs, liver or abdomen. Both right and left sided heart failure may cause fatigue and shortness of breath, or trouble breathing. All of these are symptoms of Heart Failure, as well as swelling in the ankles, feet, legs and abdomen.

Before a diagnosis of Heart Failure can be made, physicians must rule out other causes for these symptoms. It is also important for physicians to determine what disease or condition is causing the heart failure (CAD, hypertension, diabetes). Once a diagnosis has been made, physicians must determine how efficiently your heart is pumping blood, and how much it has been damaged.

Heart Failure doesn’t have to Mean Life Failure

Just because you have been diagnosed with heart failure, it does not necessarily mean your quality of life will fail. There has been great progress made in the treatment of Heart Failure. However, there is no cure for Heart Failure at this time.  External Counterpulsation (ECP) therapy, implantable defibrillators, various medications, and lifestyle changes are often used to combat and treat Heart Failure.

1 National Library of Medicine and the National Institute of Health. http://www.nlm.nih.gov/medlineplus/heartfailure.html

ACS Diagnostics, Inc.


There are five tenants that ACSD has built its foundation upon: commitment, quality, service, reliability, and trust. These pillars have provided over 30 years of strength and stability.


ACSD is committed to delivering leading technology and innovative solutions to the cardiology community. We work diligently to bring you tomorrow’s technology today.


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