Cardiac contractility modulation in patients with advanced heart failure

@article{Kahwash2013CardiacCM,
  title={Cardiac contractility modulation in patients with advanced heart failure},
  author={Rami Kahwash and Daniel Burkhoff and William T. Abraham},
  journal={Expert Review of Cardiovascular Therapy},
  year={2013},
  volume={11},
  pages={635 - 645}
}
Cardiac contractility modulation (CCM) is a novel device-based therapy for heart failure that involves applying electrical signals during the absolute refractory period of the myocardial action potential. This therapy has been shown to augment the strength of left ventricular contraction independent of myocardial oxygen consumption in animal models as well as human studies of patients with heart failure and reduced ejection fractions. The mechanism underlying CCM is an alteration of myocardial… 
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Cardiac Contractility Monitoring: an Important Therapy in the Treatment of Advanced Heart Failure
TLDR
CCM is a novel device-based therapy which delivers an electrical stimulus during the absolute refractory period and has been shown to improve heart failure symptoms, exercise tolerance, and quality of life.
Cardiac Contractility Modulation in Heart Failure: Mechanisms and Clinical Evidence
TLDR
New developments of a two-lead system have allowed for expansion into a broader array of patient populations, including those with AF, while maintaining the safety and efficacy of this therapy.
Cardiac contractility modulation improves cardiac function in a rabbit model of chronic heart failure
TLDR
In conclusion, CCM benefits cardiac function and electrophysiological characteristics in rabbit model of chronic heart failure, perhaps due to the up regulation of SERCA2a expression.
Cardiac Resynchronization Therapy and Cardiac Contractility Modulation in Patients with Advanced Heart Failure: How to Select the Right Candidate?
Matching Imaging and Remodulation Effects: Benefits of Cardiac Contractility Modulation Shown by Global Longitudinal Strain: A Case Report
TLDR
A case of a patient treated with percutaneous coronary intervention in the setting of acute coronary syndrome without persistent ST-segment elevation, with the best medical therapy for decompensated HF, where the patient demonstrated a marked improvement in exercise effort and quality of life.
Optimizer smart in the treatment of moderate-to-severe chronic heart failure.
TLDR
CCM therapy is safe and effective in reducing heart failure hospitalization and improving heart failure symptoms, quality of life and functional performance and this novel device-based therapeutic offers benefits to patients who do not otherwise qualify for cardiac resynchronization therapy.
Outcomes of Cardiac Contractility Modulation: A Systematic Review and Meta-Analysis of Randomized Clinical Trials
TLDR
Short-term treatment with CCM may improve MLFHQ without significant difference in 6MWD, arrhythmic events, HF hospitalizations, all-cause hospitalizations; there is a trend towards increased pacemaker/ICD device malfunction.
Recent Advances in the Optimization of Cardiac Resynchronization Therapy
TLDR
The mechanisms and benefits of CRT, clinical trials, and guidelines for CRT along with a focus on recent updates from the past 3 to 5 years and glimpse into future directions are discussed.

References

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Electrical Modulation of Cardiac Contractility: Clinical Aspects in Congestive Heart Failure
TLDR
The study suggests that unlike modified pacing techniques, delivery of the signal to the left ventricle during the refractory period resulted in a rapid increase in myocardial contractility and improved hemodynamic performance.
Does Contractility Modulation Have a Role in the Treatment of Heart Failure?
TLDR
A review of clinical studies investigating the impact of Cardiac contractility modulation on exercise tolerance and quality of life in patients with chronic heart failure outlines additional studies underway to further clarify the role of CCM in the treatment of heart failure.
Cardiac Contractility Modulation With the Impulse Dynamics Signal: Studies in Dogs With Chronic Heart Failure
TLDR
Pre-clinical results to date with the Impulse Dynamics CCM signal indicate that this non-pharmacologic therapeutic modality can provide short-term positive inotropic support to the failing heart and as such, may be a useful adjunct in the treatment of advanced heart failure.
Therapy with cardiac contractility modulation electrical signals improves left ventricular function and remodeling in dogs with chronic heart failure.
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Chronic electrical stimulation during the absolute refractory period of the myocardium improves severe heart failure.
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Nonexcitatory, cardiac contractility modulation electrical impulses: feasibility study for advanced heart failure in patients with normal QRS duration.
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