Improvement of long-term survival by cardiac contractility modulation in heart failure patients: A case–control study

Liu, Ming; Fang, Fang; Luo, Xiaoting; Shlomo, Ben-Haim; Burkhoff, Daniel; Chan, Joseph Yat‐Sun; Chan, CW; Cheung, Lily; Rousso, Benny; Gutterman, David D.; Yu, Cheuk‐Man

doi:10.1016/j.ijcard.2016.01.071

Cited by 43 publications

(23 citation statements)

References 14 publications

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“…[18] A more recent study has also demonstrated a greater benefit of CCM in patients with moderate vs. severe reductions in EF in terms of all-cause mortality and heart failure hospitalizations. [19] These finding support an ongoing controlled randomized clinical trial of CCM+OMT vs. OMT alone in patients with moderately reduced EF (25-45%). [20] They have also prompted the Task Force that developed the 2016 ESC Guidelines for Diagnosis and Treatment of Acute and Chronic Heart Failure to comment on CCM.…”

Section: Effects Of Ccm On Cardiac Function and Remodelingsupporting

confidence: 72%

“…Follow up at 1, 2 and 5 years demonstrated a survival with CCM better than predicted by SHFM at each time point. In a recent study with the longest follow-up, Liu et al [19] examined mortality in 41 consecutively implanted (CCM) patients from a single practice. They compared mortality, hospitalization, and the composite outcome with a contemporaneous control group from a registry of patients in the same practice.…”

Section: Effects Of Ccm On Cardiac Function and Remodelingmentioning

confidence: 99%

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

Coats¹

2017

ICFJ

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Substantial advances in the medical treatment of HFrEF have improved survival and cardiac function in these patients. However despite the use of optimal medical therapy (OMT) and the use of recommended devices in those in whom they are indicated, persistent symptoms limit activity and adversely affect lifestyle in a substantial number of patients. For these patients newer devices other than ICD and CRT may offer an improvement in symptoms and/or survival. This paper reviews the evidence for the use of CCM and discusses in which patients it may be considered as recommended in the recent guidelines. CCM is an established treatment in the management of moderate to severely symptomatic heart failure with reduced EF and normal QRS duration. CCM impulse delivery is associated with acute improvements in cardiac contractility. Chronic changes include reversion from fetal to adult gene expression profiles in the heart, improved calcium handling, restorative ventricular remodeling, and improved cardiac function. The recent 2016 ESC/HFA guidelines for the management of heart failure considered that most of these newer devices had insufficient clinical trial data for a formal recommendation, but in the case of one, cardiac contractility modulation (CCM) the guidelines describe CCM as being something to be considered in selected patients with HF. This is based on a demonstrated improvement in exercise tolerance (peak VO2) and quality of life (by Minnesota LWHF questionnaire, MLWHFQ) produced by CCM in an individual patient data meta- analysis of all the randomised controlled trials of CCM.

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Section: Effects Of Ccm On Cardiac Function and Remodelingsupporting

confidence: 72%

Section: Effects Of Ccm On Cardiac Function and Remodelingmentioning

confidence: 99%

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

Coats¹

2017

ICFJ

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“…There are reports of lower long-term mortality rates in heart failure patients with NYHA (II-III) and QRS ≤ 130 ms when treated by CCM than predicted for the cohort. These findings warrant substantiation in a prospective study [33][34][35].…”

Section: Cardiac Contractility Modulation (Ccm)mentioning

confidence: 69%

“…The ICD technology evolved from devices that delivered therapy through epicardial patch electrodes introduced by thoracotomy in 1980s [34], to those using transvenous leads advanced to the right ventricle for detection and treatment of tachyarrhythmia and to provide bradycardia-pacing support in 1990s. The transvenous ICD reduced the morbidity and risk associated with thoracotomy implants.…”

Section: Subcutaneous Implantable Cardioverter Defibrillator (S-icd)mentioning

confidence: 99%

Cardiac Contractility Modulation Device and Subcutaneous Implantable Cardioverter Defibrillator Combination: A New Hope for Heart Failure Patients with Low Ejection Fraction and Narrow QRS Complex

Al‐Ghamdi¹

2016

J Cardiovasc Med Cardiol

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“…Модуляция сердечной сократимости при сердечной недостаточности роспективный анализ амбулаторных пациентов выявил эффективность более раннего начала терапии МСС [36,37].…”

Section: Modulation Of Cardiac Contractility In Heart Failureunclassified

Modulation of Cardiac Contractility – a New Method in the Treatment of Heart Failure

Petrukhina

Tereshchenko

Жиров

2016

Racionalʹnaâ farmakoterapiâ v kardiologii

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Российский кардиологический научно-производственный комплекс Россия, 121552, Москва, ул. 3-я Черепковская, 15а Обзор анализирует новый метод лечения больных c хронической сердечной недостаточностью (ХСН) и низкой фракцией выброса -мо-дуляцию сердечных сокращений (МСС). МСС осуществляется за счет подачи электрических импульсов в абсолютно рефрактерный мио-кард желудочков, что приводит к положительному инотропному эффекту без увеличения потребности миокарда кислородом. Исполь-зование метода не зависит от длительности комплекса QRS, следовательно, может быть показана пациентам, не подходящим для про-ведения сердечной ресинхронизирующей терапии (СРТ). Следует отметить, что применение МСС для лечения ХСН должно начинать-ся только на фоне максимально активной терапии при ее недостаточной эффективности. Это не альтернатива, а дополнение к макси-мально активной терапии больных. Клинические исследования в первую очередь нацелены на пациентов с нормальной длительностью QRS ввиду того, что СРТ является оптимальной возможностью лечения пациентов с удлиненным QRS. Обсуждаются результаты, полученные при оценке клинической эффективности и безопасности лечения больных ХСН (n=617) в рандомизированных клинических исследо-ваниях FIX-HF-3 (n=25), FIX-HF-4 (n=164), FIX-HF-5 (n=428). Исходные характеристики пациентов были аналогичны для всех 3-х ис-следований. Все участники получали оптимальную медикаментозную терапию, имели нормальную длительность QRS. Все пациенты были II и III функционального класса (по NYHA). В исследованиях проводился анализ изменений функционального класса NYHA, фракции выброса, пикового потребления кислорода (VO 2 ), предшественника мозгового натрийуретического пептида (NT-proBNP). Проводилась оценка качества жизни по результатам Миннесотского опросника, уровень смертности сравнивался с прогнозируемым по шкале MAGGIC. МСС благоприятно влияла на выживаемость и качество жизни пациентов. Однако для оценки долгосрочных эффектов от про-ведения МСС требуется больше данных.Ключевые слова: хроническая сердечная недостаточность, имплантируемые устройства, модуляция сердечной сократимости. The review analyzes new treatment for patients with chronic heart failure (CHF) with low ejection fraction -cardiac contractility modulation (CCM). CCM is carried out by supplying electric signals to an absolutely refractory ventricular myocardium, to elicit a positive inotropic effect without increasing myocardial oxygen consumption. These effects are independent on QRS duration; consequently, the therapy might be beneficial for patients who are not candidates for cardiac resynchronization therapy (CRT). It should be noted that the use of CCM treatment of CHF should begin only with maximum active therapy when its efficacy is not enough. It is not an alternative, but complement to the most active treatment of patients. Clinical studies primarily focused on patients with normal QRS duration because the CPT is optimal treatment of patients with prolonged QRS. The article focuses on the prerequisites for the development of the method ...

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Improvement of long-term survival by cardiac contractility modulation in heart failure patients: A case–control study

Cited by 43 publications

References 14 publications

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

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

Cardiac Contractility Modulation Device and Subcutaneous Implantable Cardioverter Defibrillator Combination: A New Hope for Heart Failure Patients with Low Ejection Fraction and Narrow QRS Complex

Modulation of Cardiac Contractility – a New Method in the Treatment of Heart Failure

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