Cardiac Contractility Modulator Insertion for Heart Failure: A Single Centre Australian Experience

Introduction: Cardiac contractility modulation (CCM) device therapy is now recommended as a treatment for symptomatic systolic heart failure with a narrow QRS, on maximal medical therapy. CCM enhances ventricular contraction, independent of the ventricular synchrony and thus is an option for heart failure who are ineligible for cardiac resynchronisation therapy. CCM studies have demonstrated improvements in exercise tolerance and quality of life. Methods: Between August 2015 and December 2016, five patients underwent CCM device implantation at our institution. We compared clinical and echocardiographic parameters (Table 1) at baseline and follow-up for all patients. Results: Five patients (3 males, mean age 61 ± 10years) received CCM device implantation, without acute complications. Mean LVEF at baseline 28 ± 7% with baseline QRS 118 ± 12 msec. Aetiology of cardiomyopathy was ischaemic in 40% and non-ischaemic in 60%. 100% of patients were on ACE inhibitors and beta blockers with 60% receiving spironolactone at baseline and follow-up. Baseline NYHA status was Class II (n = 2) or III (n = 3). All patients had an improvement in their NYHA status by at least 1 class. CCM therapy was delivered 93 ± 5% of the time. No MACE events for follow-up period (328 ± 189 days). Conclusion: In our single centre Australian cohort, CCM therapy resulted in an improvement in key echo parameters (LVEF, LVEDD) and functional status (NYHA). Larger studies are required to determine long-term efficacy and outcomes.