scholarly journals Possibilities and perspectives of using cardiac contractility modulation in patients with chronic heart failure and atrial fibrillation

Kardiologiia ◽  
2019 ◽  
Vol 59 (2S) ◽  
pp. 4-14
Author(s):  
T. M. Uskach ◽  
S. N. Tereshchenko ◽  
T. A. Pavlenko ◽  
I. V. Zhirov ◽  
O. V. Sapelnikov ◽  
...  
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Continuous Process ◽  
Cardiac Contractility ◽  
Life Quality ◽  
Cardiac Resynchronization ◽  
Cardiac Contractility Modulation ◽  
Patients With Heart Failure ◽  
All Cause Mortality ◽  
Care Problems

Heart failure is one of the main health care problems all over the world. Although, there are many drugs with proven effectiveness and hi-tech devices, there is a continuous process of searching new possibilities in heart failure prophylaxis going on because of huge economic burden and impact on life quality. Developing of atrial fibrillation in heart failure patients increases the risks of hospitalization and all-cause mortality. Appearance of new Optimizer Smart® system of cardiac contractility modulation is a perspective way of treatment in patients with heart failure and atrial fibrillation, who are not a candidate or have not got a good result from cardiac resynchronization therapy (CRT).

scholarly journals Cardiac Contractility Modulation Therapy for Heart Failure – First Romanian Experience 

2021 ◽  
Vol 31 (3) ◽  
pp. 609-614
Author(s):  
Diana TINT ◽  
◽  
Sorin MICU ◽  
Keyword(s):  
Heart Failure ◽  
Nyha Class ◽  
Cardiac Contractility ◽  
Case Series ◽  
Cardiac Resynchronization ◽  
Cardiac Contractility Modulation ◽  
Reduced Ejection Fraction ◽  
Cardiac Contractile ◽  
Patients With Heart Failure

Aim: The purpose of this study is to present the first Romanian case-series of patients with heart failure with reduced ejection fraction (HFrEF), supported with the newest generation of cardiac contractility modulation (CCM) device. Methods and results: 16 patients (15 men), aged 66.6±7.49 years, were supported with OPTIMIZER® smart IPG CCMX10 device and followed-up for an average duration of 385.75±326.32 days. The etiology of HF was ischemic in 13 patients (81%), 8 patients (50%) had atrial fibrillation, mean creatinine clearance value was 55.8±13.87 ml/min, and 5 patients (31,2%) had diabetes mellitus. All patients were supported with an implanted cardio verter-defibrillator (ICD), while 5 patients (31.2%) had cardiac resynchronization therapy (CRT) on top. The pharma cological treatment has been optimized in all patients. Six months after implantation, the LVEF has increased from 25.93%±6.21 to 35.5%±4.31 (p=0.00002), NYHA class improved from 3.18±0.4 to 1.83±0.38 (p<0.0001), and exercise tolerance evaluated with 6 minute walking test (6MWT) increased (from 321.87±70.63m to 521.41±86.43m; p<0,00001). Three patients (18,7%) died during the follow-up period after 48, 108 and 545 days (one non-cardiac death). Conclusions: Cardiac contractile therapy is a feasible, safe, and useful therapy for patients with HFrEF whose symptomatology is not improved with optimal standard therapy.

scholarly journals Left ventricular myocardial cellular perfusion against the background of cardiac contractility modulation in patients with heart failure and atrial fibrillation

2021 ◽  
Vol 26 (7) ◽  
pp. 4238
Author(s):  
V. A. Amanatova ◽  
A. A. Safiullina ◽  
T. M. Uskach ◽  
A. A. Ansheles ◽  
S. N. Tereshchenko ◽  
...  
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Myocardial Perfusion ◽  
Photon Emission ◽  
Cardiac Contractility ◽  
Left Ventricular ◽  
Emission Computed Tomography ◽  
Cardiac Contractility Modulation ◽  
Medication Therapy ◽  
Patients With Heart Failure

Aim. To assess the effect of cardiac contractility modulation (CCM) in patients with heart failure (HF) and atrial fibrillation (AF) on left ventricular (LV) myocardial cellular perfusion using perfusion single photon emission computed tomography (SPECT).Material and methods. 99mTc-MIBI SPECT gated myocardial perfusion imaging was performed in 60 patients with HF and AF before implantation of CCM device and after 6-months follow-up. All patients received long-term optimal medication therapy for HF. Results. The results obtained indicate a significant positive effect of CCM use in patients with HF and AF on LV ejection fraction (increase from 22 [18;30] to 25,5 [19;38] (p=0,002)), LV volume (decrease in LV end-systolic volume from 187 [114;238] to 154 [100;201] (p=0,001), end-diastolic volume from 229 [174;290] to 209 [159;259] (p=0,007)), as well as myocardial perfusion values. There is a favorable myocardial perfusion dynamics, which was more pronounced in nonischemic HF: increase in SRS from 6 [5;9] to 8,0 [6;11] after 6 months (p=0,01)). The extent of impaired perfusion significantly decreases from 12 [9;17] to 9 [6;16] (p=0,04). An indicator reflecting the total impairment of LV myocardial perfusion significantly decreases: total perfusion deficit decreased from 10 [8;14] to 7 [6;14] after 6 months (p=0,02), compared with ischemia-related HF.Conclusion. Perfusion SPECT makes it possible to assess the myocardial cellular perfusion during CCM therapy in patients with HF of various origin and AF. CCM therapy improves myocardial contractility and perfusion in patients with HF and AF.

scholarly journals Cardiac index in atrio- and interventricular delay optimized cardiac resynchronization therapy and cardiac contractility modulation

2015 ◽  
Vol 1 (1) ◽  
pp. 89-91 ◽  
Author(s):  
J. Tumampos ◽  
N. Wulf ◽  
H. Kühnert ◽  
O. Solbrig ◽  
J. Querengässer ◽  
...  
Keyword(s):  
Heart Failure ◽  
Cardiac Index ◽  
Cardiac Resynchronization Therapy ◽  
Cardiac Contractility ◽  
Left Ventricular ◽  
Cardiac Resynchronization ◽  
Resynchronization Therapy ◽  
Cardiac Contractility Modulation ◽  
Heart Failure Patients ◽  
Qrs Duration

AbstractCardiac resynchronization therapy (CRT) is an established therapy for heart failure patients and improves quality of life in patients with sinus rhythm, reduced left ventricular ejection fraction (LVEF), left bundle branch block and wide QRS duration. Since approximately sixty percent of heart failure patients have a normal QRS duration they do not benefit or respond to the CRT. Cardiac contractility modulation (CCM) releases nonexcitatoy impulses during the absolute refractory period in order to enhance the strength of the left ventricular contraction. The aim of the investigation was to evaluate differences in cardiac index between optimized and nonoptimized CRT and CCM devices versus standard values. Impedance cardiography, a noninvasive method was used to measure cardiac index (CI), a useful parameter which describes the blood volume during one minutes heart pumps related to the body surface. CRT patients indicate an increase of 39.74 percent and CCM patients an improvement of 21.89 percent more cardiac index with an optimized device.

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