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February 16, 2017HeartRhythm Case ReportsOpen Access

Cardiac contractility modulation therapy: Are there superresponders?

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Key result

Cardiac contractility modulation therapy improved left ventricular ejection fraction from 20-25% to 40-45% and NYHA functional class from III to I at 3 months in a patient with dilated cardiomyopathy.

Why the study?

Does cardiac contractility modulation therapy improve symptoms and cardiac function in a patient with dilated cardiomyopathy, narrow QRS, and reduced LVEF?

Population

1 35-year-old male with dilated cardiomyopathy, LVEF 25%, narrow QRS, NYHA class III despite…

Design

Case_report

Follow-up

3 months

Authors

BABandar Al‐GhamdiASAzam ShafquatYMYaseen Mallawi

Discussion

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Overview

Hypothesis-generating for CCM in narrow-QRS HFrEF; prospective trials needed before adoption.

Study Design

Type

Case Report (n=1)

Structured PICO

Does cardiac contractility modulation therapy improve symptoms and cardiac function in a patient with dilated cardiomyopathy, narrow QRS, and reduced LVEF?

P
Population
A 35-year-old male with dilated cardiomyopathy, LVEF of 25%, and NYHA class III symptoms despite guideline-directed medical therapy, followed for 3 months after CCM implantation.
I
Intervention
Cardiac contractility modulation (CCM) therapy using the Optimizer IVs system.
O
Outcome
Improvement in heart failure symptoms (NYHA class), exercise capacity (6-minute walk distance, VO2max), and left ventricular ejection fraction (LVEF) at 3-month follow-up.surrogate

Cardiac contractility modulation therapy may provide significant symptomatic and functional improvement in patients with HFrEF and narrow QRS who are refractory to medical therapy and ineligible for CRT.

Limitations

  • Single case report
  • Prospective studies are needed to confirm these findings

Cite This Study

Al‐Ghamdi et al. (2017) conducted a case report in Dilated cardiomyopathy with heart failure (n=1). Cardiac contractility modulation (CCM) vs. Baseline was evaluated on Left ventricular ejection fraction (LVEF). Cardiac contractility modulation therapy improved left ventricular ejection fraction from 20-25% to 40-45% and NYHA functional class from III to I at 3 months in a patient with dilated cardiomyopathy.

synapsesocial.com/papers/6a95a6f8eae36b2f6ea8e86bhttps://doi.org/10.1016/j.hrcr.2017.02.004
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Cardiac contractility modulation in non-responders to cardiac resynchronization therapy2008 · 80 citations
  2. 2Cardiac contractility modulation: first experience in heart failure patients with reduced ejection fraction and permanent atrial fibrillation2014 · 36 citations
  3. 3Cardiac Contractility Modulation for Heart Failure: A Meta‐Analysis of Randomized Controlled Trials2012 · 22 citations
  4. 4Randomized, double blind study of non-excitatory, cardiac contractility modulation electrical impulses for symptomatic heart failure2008 · 240 citations
  5. 5New devices in heart failure: an European Heart Rhythm Association report: Developed by the European Heart Rhythm Association; Endorsed by the Heart Failure Association2013 · 72 citations