Cardiac contractility modulation was associated with lower 6-year mortality compared to no device in chronic heart failure (15.47% vs 20.90%; RR 0.63, 95% CI 0.43-0.92).
Cohort (n=736)
Yes
Does cardiac contractility modulation device placement reduce mortality in patients with chronic heart failure?
Cardiac contractility modulation device placement is associated with significantly decreased long-term mortality at 6 years compared to no CCM in patients with chronic heart failure.
Effect estimate: RR 0.63 (95% CI 0.43-0.92)
Absolute Event Rate: 15.47% vs 20.9%
Abstract Introduction Cardiac contractility modulation (CCM) is an innovative device-based therapy developed to address the unmet needs of patients with chronic heart failure, particularly those with reduced or midrange left ventricular ejection fraction(LVEF) who remain symptomatic despite optimal medical therapy and are not candidates for cardiac resynchronization therapy (CRT). The therapy’s benefits are particularly notable in patients with LVEF between 25% and 45% and narrow QRS duration, a population not well served by CRT. CCM has emerged as a safe and effective adjunct to guideline-directed medical therapy to improve quality of life and functional status of patients. Data is limited in regards to its effect on long-term outcomes like mortality and hospitalization rates. Our aim was to see the efficacy and safety of CCM devices in such patients. Methods This retrospective cohort study utilized the TriNetX Nationwide deidentified database. Propensity score matching was performed to compare outcomes between 368 patients in each group with CCM device and without CCM device from 01/01/2019 to 01/01/2025. Results After propensity matching, each cohort consisted of 368 patients. Among patients with CCM device placement,mean age was 66.7 years while 51.50% were white,16.71% were African Americans, while 4.90% were Hispanics. Among the patients with CCM device, ED visits in 1 month was 11.68% compared to 5.43% without CCM placement (OR 2.3, 1.36 -3.99). Follow up in 6 months showed that death due to all cause was 6.5% in CCM patients compared to 5.16% in non-CCM patients (RR 1.25, CI 0.67-2.32), 3.2% in CCM, 8.9% non-CCM (RR 1.13, CI 0.64-1.85) in 1 year. Follow up in 6 years showed significant difference in mortality in CCM (15.47%) vs. non-CCM patients (20.90%), (RR 0.63, CI: 0.43-0.92). On follow up until 6 years, development of new CKD was found to be lower in CCM patients compared to non-CCM patients 0.75 % (0.41-1.40). Stroke event was lower in CCM group (4.35%) compared to non-CCM cohort 6.79% (0.62, 0.33-1.19). Risk of MI was comparable in CCM (13.8%) vs non-CCM (12.2%) cohort (1.16, 0.75-1.18). Conclusion Our study showed that there is statistically significant decreased mortality in CCM patients compared to non-CCM patients in 6 years follow up. This abstract is funded by: None
Khadka et al. (Fri,) conducted a cohort in Chronic heart failure (n=736). Cardiac contractility modulation (CCM) device vs. No CCM device was evaluated on All-cause mortality at 6 years (RR 0.63, 95% CI 0.43-0.92). Cardiac contractility modulation was associated with lower 6-year mortality compared to no device in chronic heart failure (15.47% vs 20.90%; RR 0.63, 95% CI 0.43-0.92).