Key result
Cardiac contractility modulation successfully improved symptoms, quality of life, and functional capacity over 6 months in a 26-year-old obese male with advanced heart failure, serving as a bridge to transplant.
Why the study?
The use of cardiac contractility modulation as a bridge to transplant in an obese patient with advanced heart failure had not been previously described.
Does cardiac contractility modulation improve clinical and hemodynamic parameters as a bridge to transplant in an obese patient with advanced HFrEF?
Case Report (n=1)
No
Does cardiac contractility modulation improve clinical and hemodynamic parameters as a bridge to transplant in an obese patient with advanced HFrEF?
Cardiac contractility modulation may serve as a safe and effective bridge to transplant strategy in selected patients with end-stage HFrEF who have contraindications to LVAD, such as severe obesity.
Answers are grounded in this paper and cite their sources.
May support CCM as bridge-to-transplant in obese advanced HFrEF ineligible for LVAD; hypothesis-generating and requires prospective validation.
Cardiac contractility modulation (CCM) is a novel device-based therapy in patients with heart failure with reduced ejection fraction (HFrEF). In randomized clinical trials and real-life studies, CCM has been shown to improve exercise tolerance and quality of life, reverse left ventricular remodeling and reduce hospitalization in patients with HFrEF. In this case report, we describe for the first time the use of CCM as a "bridge to transplant" in a young obese patient with advanced heart failure due to non-ischemic dilated cardiomyopathy. The patient had a poor quality of life and frequent heart failure-related hospitalizations despite the optimal medical therapy and, due to obesity, a suitable heart donor was unlikely to be identified in the short term and due to severe obesity risk of complications after implantation of a left ventricular assist device (LVAD) was very high.
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Masarone et al. (2022) conducted a case report in Advanced Heart Failure (n=1). Cardiac contractility modulation (Optimizer Smart) was evaluated on Clinical and functional improvement (NYHA class, MLWHFQ score, LVEF, VO2 peak). Cardiac contractility modulation successfully improved symptoms, quality of life, and functional capacity over 6 months in a 26-year-old obese male with advanced heart failure, serving as a bridge to transplant.
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