The Prospective Evaluation of Enhanced Extemal Counterpulsation in Congestive Heart Failure (PEECH) trial demonstrated that enhanced external counterpulsation (EECP) therapy increased exercise duration and improved functional status and quality of life without affecting peak oxygen consumption.The authors present data from a prespecified subgroup of elderly patients (65 years or older) enrolled in the PEECH trial.The 2 co-primary end points were the percentage of subjects with a >60-second increase in exercise duration and the percentage of subjects with a >1.25-mL/kg/min increase in peak volume of oxygen consumption.At 6-month follow-up,the exercise responder rate was significantly higher in EECP patients compared with controls (P=-.008).Further,in contrast to the overall PEECH study,the EECP group demonstrated a significantly higher responder rate for peak oxygen consumption (P=.017).The authors conclude that an older subgroup of PEECH subjects confirms the beneficial effect of EECP in patients with chronic,stable,mild-to-moderate heart failure.