Cardiac Contractility Modulation and Baroreflex Activation Therapy in Heart Failure Patients

Despite advances in medical therapy, heart failure with reduced ejection fraction (HFrEF) is still a leading cause of mortality, hospitalizations, and healthcare costs. In this review, we describe two novel, implantable devices for the treatment of patients with HFrEF, cardiac contractility modulation (CCM), and baroreflex activation therapy (BAT), and summarize literature regarding these devices from the last 5 years.

CCM improves quality of life and functional capacity as assessed by the Minnesota Living with Heart Failure Questionnaire (MLHFQ) score, 6-min hall walk test (6MHWT) distance, New York Heart Association (NYHA) functional class, peak oxygen consumption (pVO₂), heart failure (HF) hospitalizations, and mortality. BAT improves MLHFQ, 6-min walk test distance, NYHA functional class, and HF hospitalizations. Both devices have been shown to be safe. CCM and BAT have been shown to be safe and effective treatment modalities for HFrEF. CCM has been approved for use in Europe and has been implanted in thousands of patients. BAT has also been approved in Europe and continues to show promise in treating patients with HFrEF who fail optimal medical therapy (OMT). At present, both therapies are considered investigational in the USA.