Cardiac contractility modulation

Cardiac Kontraktilitätsmodulation (English cardiac contractility modulation CCM ) is a method for the treatment of systolic heart failure. There must be a symptom according to NYHA class II-III and a left ventricular ejection fraction of max despite optimal medical therapy. 35 % present.

About one electrode in the region of the ventricular septum is performed by a special pacemaker stimulation in the absolute refractory period of cardiac excitation. This does not lead to contraction ( nichtexzitatorische stimulation ), but a change in the calcium metabolism of myocytes and thus to improved heart muscle contraction. This leads to an increase in maximal oxygen consumption but not increased cellular oxygen consumption. It is a better resilience and thus increase the quality of life detectable, but not a life extension.

Can not be applied to the procedures for atrial fibrillation, extrasystoles and a higher grade AV block of more than 300 ms. With a width of the QRS complex of more than 120 ms, a cardiac resynchronization therapy using biventricular pacemaker should be considered, with a width of more than 150 ms, the resynchronization is superior.

The method is since 2004 in clinical trials, but could not win any relevant meaning to the present day (2012 ) and is not currently mentioned in the standard clinical textbooks.

Itemization

• Therapeutic procedures in cardiology