Background: Cardiac Contractility Modulation therapy is a novel device-based technology, which may be used in selected heart failure patients. CCM therapy involves applying biphasic, high-voltage (≈7.5 V) and long-duration (≈20 milliseconds) electric signals to the right ventricular septal wall during the absolute myocardial refractory period, which invokes biochemical and cellular changes in the failing myocardium thus improving contractility. The aim of this study is to report the outcomes in the first ten patients implanted with a CCM device in the United Kingdom.
Methods: This was a retrospective study. 10 patients who met the inclusion criteria (EF 25-45%, NYHA class 3 or 4 and QRS duration less than 130 ms) were implanted with a CCM device in 2018. As part of their follow-up they underwent regular review by the heart failure team. We report the changes in ejection fraction, NYHA class and The Minnesota Living with Heart Failure Questionnaire (MLHFQ) scores over the follow-up period.
Results: The mean age of the patients was 68.3 ± 7.8. Six of the patients were male and the majority of patients (90 %) had an ischaemic cardiomyopathy. The average follow-up in months was 21.30 ± 2.2. Overall, the ejection fraction improved from 26.2% ± 4.4% to 31.8% ± 3.6% at final follow-up (p=0.40) and quality of life as measured by the MLHFQ improved significantly from 56.3 ± 19.6 to 34.0 ± 21.8 (p≤0.01). (Figure 1) All patients improved at least one NYHA class. Overall, the NYHA class improved from 2.80 ± 0.92 to 1.7 ± 0.68 (p=0.77).
Conclusion: CCM therapy resulted in an improvement in ejection fraction and quality of life in this patient cohort, which is consistent with previous clinical trial data. CCM therapy provides a potential new treatment option for these patients who would not be eligible for cardiac resynchronisation therapy.