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IPER Forms:

Reporting of clinical data is done on the following forms: –

The PRE-EECP form - records the patient’s health status at the time of entry into the Registry. This form should be filled within 5 days of the patient starting the first session.

The 35th hour Continuation form - records the patient’s health status at the time of completion of the 35th hour of EECP treatment. This form is used only for patients who are continuing treatment beyond 35 hours.

The POST-EECP form- records the patient’s health status at the time of the last hour of EECP treatment. This may be less than, equal to or more than 35 hours. If a patient misses five consecutive treatment hours he/she is considered to have completed treatment.

The FOLLOW-UP form- records the patient’s health status and clinical events at the six month and one and two year anniversaries of the start of EECP treatment. The time intervals always refer to the time since the first day of the initial course of EECP treatment.

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