Enhanced external counterpulsation (EECP) is a noninvasive circulatory assist device that has recently emerged as a treatment option for refractory angina in left ventricular (LV) dysfunction.This 2-year cohort study describes the long-term follow-up of patients who had severe LV dysfunction that was treated with EECP for angina pectoris and reports clinical outcomes,event-free survival rates,and the incidence of repeat EECP.This study included 363 patients who had refractory angina and LV ejection fraction < or =35%.