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Evaluation of Cardiac Contractility Modulation Therapy in 2D Human Stem Cell-Derived Cardiomyocytes
Published on: December 16, 2022
Cardiac contractility modulation therapy in advanced systolic heart failure
Alexander R Lyon1, Michael A Samara, David S Feldman
1Cardiovascular Biomedical Research Unit, Royal Brompton Hospital, Sydney Street, London SW3 6NP, UK.
Nature Reviews. Cardiology
|August 14, 2013
Summary
Cardiac contractility modulation (CCM) uses nonexcitatory electrical signals to improve heart function without increasing oxygen demand. This therapy may benefit heart failure patients ineligible for other treatments.
Area of Science:
- Cardiology
- Biomedical Engineering
Background:
- Cardiac contractility modulation (CCM) applies nonexcitatory electrical signals during the absolute refractory period to enhance myocardial contractility.
- This approach aims for a positive inotropic effect without increasing myocardial oxygen consumption, offering a potential therapy for heart failure.
Approach:
- CCM therapy utilizes double biphasic voltage pulses delivered to the right ventricular interventricular septum.
- Preclinical and clinical studies investigate the modulation of cardiomyocyte Ca(2+) fluxes and phospholamban phosphorylation as mechanisms of action.
Key Points:
- CCM effects are independent of QRS duration, suggesting utility in patients unsuitable for cardiac resynchronization therapy.
- Studies show CCM improves cardiac reverse remodeling, contractility, exercise tolerance, and quality of life.
- While generally safe, CCM has not yet demonstrated reductions in heart failure hospitalizations or mortality.
Conclusions:
- CCM is an emerging therapy for heart failure with reduced ejection fraction.
- Further research is ongoing to define the optimal patient population and gather long-term outcome data.
- CCM is currently available in Europe, with ongoing trials to validate its clinical effectiveness.
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