A method of operating a counterpulsation device (CPD) in a human or animal subject is disclosed, the method including: receiving a heart beat signal indicative of the heart beat of the subject providing counterpulsation therapy by controlling the pressure supplied to a CPD drive line in pneumatic communication with the CPD to cause the CPD to alternately fill with blood and eject blood with a timing that is determined at least in part based on the heart beat signal while providing counterpulsation therapy, receiving a CPD drive line pressure signal indicative of the pressure in the CPD drive line and adjusting the pressure supplied to the drive line based at least in part on the drive line pressure signal.
