External Counterpulsation

Twenty patients in cardiogenic shock following myocardial infarction were treated with external counterpulsation. Eleven patients died during or soon after treatment. One patient survived for three days and another for three weeks; both died in the hospital of complications apparently unrelated to counterpulsation. Seven patients were discharged from the hospital and remained well. The patients who responded to external counterpulsation did so within the first few hours. There seemed to be no benefit in applying counterpulsation for more than six hours. Sequential analysis of mortality statistics indicated that the 45% survival rate (which included the two short-term survivors) was a significant improvement (P<.01) over the usual 15% survival rate in cases of cardiogenic shock. (JAMA229:1441-1450, 1974)