PMID- 36367992
OWN - NLM
STAT- MEDLINE
DCOM- 20230112
LR  - 20230112
IS  - 1536-3686 (Electronic)
IS  - 1075-2765 (Linking)
VI  - 30
IP  - 1
DP  - 2023 Jan-Feb 01
TI  - One-Year Outcome of Cardiac Contractility Modulation in Patients With Reduced 
      Ejection Fraction, Atrial Fibrillation, and Previous Resynchronization: A Pilot 
      Study.
PG  - e10-e16
LID - 10.1097/MJT.0000000000001579 [doi]
AB  - BACKGROUND: After 6 months of therapy, cardiac contractility modulation (CCM) has 
      been shown to improve symptoms, exercise tolerance, and quality of life as well 
      as reduce the rate of hospitalizations in patients with heart failure with 
      reduced left ventricular ejection fraction (HFrEF), but long-term effects data 
      are lacking, with no randomized trial to date. STUDY QUESTION: What is the 
      long-term benefit of the CCM device implantation in symptomatic patients with 
      severe, optimally treated HFrEF? STUDY DESIGN: We conducted a prospective trial 
      involving patients with symptomatic HFrEF [New York Heart Association (NYHA) 
      Class III or IV, left ventricular ejection fraction (LVEF) </=35%] who were 
      supported by a CCM device. RESULTS: Twenty patients (19 men), aged 66.5 +/- 6.9 
      years, were provided with CCM therapy and followed up for an average duration of 
      321.7 +/- 113.5 days. The etiology of heart failure was ischemic in 16 patients 
      (80%), 9 patients (45%) had atrial fibrillation, 6 patients (30%) had diabetes 
      mellitus, and mean creatinine clearance value was 54.8 +/- 13.0 mL/min. Eleven 
      patients (60%) had LVEF </=25%. Although all the patients had an implanted 
      cardioverter-defibrillator, 6 of them (30%) also had resynchronization therapy. 
      The pharmacological treatment has been optimized in all patients. One year after 
      implantation, the LVEF increased from 24.68% +/- 4.5 to 34.6 +/- 5 ( P < 0.0001), 
      NYHA class improved from 3.2 +/- 0.5 to 1.4 +/- 0.5 ( P < 0.0001), and exercise 
      tolerance evaluated with a 6-Minute Walk Test increased (from 307.9 +/- 74.1 m to 
      567 +/- 99.5 m; P < 0.00001). These improvements were largely seen in the first 6 
      months. CONCLUSIONS: Over the course of a year, CCM therapy was associated with 
      improved LVEF and NYHA class, as well as significantly better exercise tolerance, 
      even in patients with atrial fibrillation and cardiac resynchronization therapy 
      and did not seem to be associated with additional significant device-related 
      problems.
CI  - Copyright (c) 2022 Wolters Kluwer Health, Inc. All rights reserved.
FAU - Tint, Diana
AU  - Tint D
AD  - Faculty of Medicine, Transilvania University, Brasov, Romania; and.
AD  - ICCO Clinics, Brasov, Romania.
FAU - Micu, Sorin
AU  - Micu S
AD  - ICCO Clinics, Brasov, Romania.
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
DEP - 20221111
PL  - United States
TA  - Am J Ther
JT  - American journal of therapeutics
JID - 9441347
RN  - 0 (Cardiotonic Agents)
SB  - IM
MH  - Humans
MH  - Male
MH  - *Atrial Fibrillation/therapy/complications
MH  - *Cardiac Resynchronization Therapy
MH  - Cardiotonic Agents
MH  - *Heart Failure/diagnosis
MH  - Pilot Projects
MH  - Prospective Studies
MH  - Quality of Life
MH  - Stroke Volume
MH  - Treatment Outcome
MH  - *Ventricular Dysfunction, Left/diagnosis
MH  - Ventricular Function, Left
COIS- The authors have no conflicts of interest to declare.
EDAT- 2022/11/12 06:00
MHDA- 2023/01/11 06:00
CRDT- 2022/11/11 15:52
PHST- 2022/09/18 00:00 [received]
PHST- 2022/09/26 00:00 [accepted]
PHST- 2022/11/12 06:00 [pubmed]
PHST- 2023/01/11 06:00 [medline]
PHST- 2022/11/11 15:52 [entrez]
AID - 00045391-990000000-00096 [pii]
AID - 10.1097/MJT.0000000000001579 [doi]
PST - ppublish
SO  - Am J Ther. 2023 Jan-Feb 01;30(1):e10-e16. doi: 10.1097/MJT.0000000000001579. Epub 
      2022 Nov 11.