1.
During 1950’s:
Kantrowitzs first described the principle: "phase
shift diastolic augmentation". In 1953,
physicians and physicists
at Harvard and elsewhere related this principle to
oxygen consumption and workload. This understanding
led to the concept of
mechanically induced “cardiac assistance”
for patients with low output syndrome, especially
cardiogenic shock.
2.
During 1960’s:
Beginning in the 1960’s research on mechanically
induced “cardiac assistance” followed
two distant paths, one
involved the use of balloon positioned inside the
descending thoracic aorta that would inflate during
diastole and deflate
at the onset of systole, and another of the vascular
beds in the lower limbs. The first came to be known
as the intra-aortic balloon (IABP). The second evolved
as to what is now referred as ECP. These early systems
were somewhat primitive by today’s standards.
But both forms of Counter pulsation clearly demonstrated
the potential for increasing
survival of the patient with myocardial infarction
cardiogenic shock as well as for relief of angina
pectoris.
In
1960’s, Three groups (Birtwell and Soroff, Dennis,
and Osborn) independently developed hydraulically
activated external counter
pulsation devices and found the technique effective
in impproving survival after myocardial infarction
complicated by cardiogenic
shock. Initial experience with a crude external counter
pulsation device used in stable angina
saw relief of angina symptoms with angiographic evidence
of increased vascularity.
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