Stymulacja modulująca kurczliwość mięśnia sercowego — opis przypadku i przegląd piśmiennictwa

Abstract

Cardiac contractility modulation (CCM) is a new implantable device that transmits electrical impulse to the heart during the absolute refractory period, which leads to an increase in myocardial contractility. This pacemaker works on several molecular levels and is dedicated to patients with heart failure (HF). The therapeutic effect is mainly due to the improvement in the circulation of calcium ions inside the cardiomyocytes. The final CCM effect leads to improved exercise capacity, increased quality of life, decreased symptoms and the number of hospitalizations as the results of HF. Device is an important alternative for patients with ineffective pharmacological therapy, who are not eligible for CRT implantation due to the narrow QRS complex, have a decreased ejection fraction, and in the New York Heart Association scale they were classified on the II–III degree. Previous studies have not demonstrated the impact of CCM on life expectancy. The effect of cardiac contractility modulation device on the improvement of everyday functioning and the reduction of hospitalization has been proven, which is important in the long-term perspective for both individual patients and the entire health care system. The case report shows an example of a patient for whom CCM was an addition to treatment.