Clinical effects of cardiac contractility modulation (CCM) as a treatment for chronic heart failure

@article{Borggrefe2012ClinicalEO,
  title={Clinical effects of cardiac contractility modulation (CCM) as a treatment for chronic heart failure},
  author={Martin Borggrefe and Daniel Burkhoff},
  journal={European Journal of Heart Failure},
  year={2012},
  volume={14}
}
Cardiac contractility modulation (CCM) signals are non‐excitatory signals applied during the absolute refractory period that have been shown to enhance the strength of left ventricular contraction without increasing myocardial oxygen consumption in studies carried out in animals and humans with heart failure and reduced ejection fraction. Studies from myocardial tissue of animals and humans with heart failure suggest that the mechanisms of these effects is that CCM drives expression of many… 

Cardiac contractility modulation: mechanisms of action in heart failure with reduced ejection fraction and beyond

TLDR
Cardiac contractility modulation (CCM) signals have been shown to improve symptoms, exercise tolerance and quality of life and reduce the rate of HF hospitalizations in patients with ejection fractions (EF) between 25% and 45%.

Cardiac Contractility Modulation in Patients with Heart Failure with Reduced Left Ventricular Ejection Fraction

TLDR
Cardiac contractility modulation could have a place in therapy and meet a relevant medical need for a specific sub-category of underserved heart failure patients with reduced left ventricular ejection fraction, according to multiple clinical and mechanistic studies.

Other Devices for Heart Failure – Cardiac Contractility Modulation (CCM)

TLDR
The evidence for the use of cardiac contractility modulation (CCM) is reviewed and in which patients it may be considered as recommended in the recent guidelines is discussed and an individual patient data meta- analysis of all the randomised controlled trials of CCM is discussed.

Cardiac contractility modulation for patient with refractory heart failure: an updated evidence-based review

TLDR
The aim of this review is to summarize the pathophysiological mechanisms, the current indications, and the recent developments regarding the new applications of the CCM for patients with chronic heart failure.

Clinical effects of long-term cardiac contractility modulation (CCM) in subjects with heart failure caused by left ventricular systolic dysfunction

TLDR
Cardiac contractility modulation provides safe and effective long-term symptomatic and functional improvement in heart failure and were associated with a safety profile similar to published device trials.

Cardiac contractility modulation: a novel approach for the treatment of heart failure

TLDR
CCM appears to be an effective, safe technology for the treatment of heart failure with reduced ejection fraction, filling an important therapeutic gap among the 2/3 of patients with heart failure who do not meet criteria for CRT.

Cardiac contractility modulation: first experience in heart failure patients with reduced ejection fraction and permanent atrial fibrillation.

  • S. RögerR. Schneider J. Kuschyk
  • Medicine
    Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology
  • 2014
TLDR
CCM signal Delivery is feasible in HF patients with permanent AF by sequential atrial-ventricular pacing, so that the atrial pacing spike is interpreted as a p wave by the CCM signal delivery algorithm.

Long term impact of cardiac contractility modulation on QRS duration.

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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.

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.

Cardiac contractility modulation with nonexcitatory electric signals improves left ventricular function in dogs with chronic heart failure.

TLDR
In dogs with HF, CCM signal delivery for 6 hours elicited marked improvement in LV function, suggesting this novel approach may represent a useful adjunctive therapy for the treatment of patients with HF.