Abstract

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 genes that are abnormally expressed in heart failure towards normal, including proteins involved with calcium cycling and the myocardial contractile machinery. Clinical studies have primarily focused on patients with normal QRS durations in view of the fact that cardiac resynchronization (CRT) is a viable option for patients with prolonged QRS duration. These studies show that CCM improves exercise tolerance as indexed by peak oxygen consumption (VO(2)) and quality of life indexed by the Minnesota Living with Heart Failure Questionnaire. The device is currently available for clinical use in countries recognizing the CE mark and is undergoing additional testing in the USA under a protocol approved by the Federal Drug Administration.

Links

Publisher Full Text

Authors

Borggrefe M, Burkhoff D

Institution

Department of Medicine (Department of Cardiology), Medical Faculty Mannheim, University of Heidelberg, Germany. martin.borggrefe@umm.de

Source

European journal of heart failure 14:7 2012 Jul pg 703-12

MeSH

Cardiac Pacing, Artificial
Gene Expression
Heart Failure
Hemodynamics
Humans
Myocardial Contraction
Myocardium
Oxygen Consumption
Stroke Volume
Ventricular Function, Left

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

22696514