Long-term clinical experience with cardiac contractility modulation therapy delivered by the Optimizer Smart system

Related Experiment Video

Updated: Nov 5, 2025

Evaluation of Cardiac Contractility Modulation Therapy in 2D Human Stem Cell-Derived Cardiomyocytes
08:47

Evaluation of Cardiac Contractility Modulation Therapy in 2D Human Stem Cell-Derived Cardiomyocytes

Published on: December 16, 2022

2.6K

Jürgen Kuschyk1, Peter Falk2, Thomas Demming2

  • 11st Department of Medicine - Cardiology, University Medical Centre Mannheim, Germany; Partner Site Heidelberg/Mannheim, German Center for Cardiovascular Research (DZHK), Mannheim, Germany.

European Journal of Heart Failure
|May 18, 2021
PubMed

Insights

Cardiac contractility modulation significantly improved quality of life and ejection fraction in heart failure patients. This therapy also reduced hospitalizations and improved survival rates compared to predictions.

Area of Science:

  • Cardiology
  • Medical Devices
  • Heart Failure Management

Background:

  • Heart failure (HF) remains a leading cause of morbidity and mortality worldwide.
  • Current treatments aim to improve symptoms, reduce hospitalizations, and enhance survival.
  • Cardiac contractility modulation (CCM) is an emerging therapy for specific HF populations.

Purpose of the Study:

  • To evaluate the long-term effects of CCM therapy using the Optimizer Smart system.
  • To assess CCM's impact on quality of life, left ventricular ejection fraction (LVEF), mortality, and hospitalizations.
  • To analyze CCM's effectiveness across different LVEF subgroups and heart rhythm statuses (atrial fibrillation vs. normal sinus rhythm).

Main Methods:

  • A prospective registry study (CCM-REG) involving 503 patients across 51 European centers.
  • Patients were stratified by LVEF terciles (≤25%, 26-34%, ≥35%) and heart rhythm (AF, NSR).
  • Outcomes including NYHA class, MLWHFQ, LVEF, hospitalization rates, and survival were assessed over 24 months using statistical tests and Kaplan-Meier analysis.

Main Results:

  • CCM therapy led to significant improvements in NYHA class and MLWHFQ scores at 6, 12, 18, and 24 months (P<0.0001).
  • At 24 months, average improvements were 0.6 in NYHA class, 10 points in MLWHFQ, and 5.6% in LVEF (all P<0.001).
  • Significant reductions in heart failure (0.74 to 0.25 events/patient-year) and cardiovascular hospitalizations (1.04 to 0.39 events/patient-year) were observed (P<0.0001).
  • LVEF improved across the cohort and in specific subgroups, including those with LVEF ≤25% and both AF and NSR.
  • Survival at 1 and 3 years was significantly better than predicted by the MAGGIC risk score in several subgroups.

Conclusions:

  • Cardiac contractility modulation therapy effectively improves functional status and quality of life in heart failure patients.
  • CCM significantly reduces heart failure hospitalization rates compared to patients' baseline history.
  • The therapy demonstrates a positive impact on LVEF and offers improved survival outcomes, outperforming risk score predictions.
Abstract

Keywords:
CCM therapyHeart failure

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