Cardiac contractility modulation therapy: Are there superresponders?

Abstract

Key Teaching Points • Heart failure is a common health care problem. • Patients with heart failure and narrow QRS complexes who are refractory to medical therapy represent a management challenge, as they are not candidates for cardiac resynchronization therapy. • Cardiac contractility modulation (CCM) therapy represents a promising therapeutic modality for these patients. • CCM is associated with increased maximal oxygen consumption and improved quality of life in patients with heart failure. • CCM may lead to left ventricular reverse remodeling, and it is expected to increase left ventricular ejection fraction (LVEF) by ~5%. • Patients with heart failure New York Heart Association functional class III and an LVEF of ≥25% respond exceptionally well to CCM therapy as suggested by subgroup analysis of large studies in this field.