Does Cardiac Contractility Modulation Therapy Reduce Atrial Fibrillation Burden?

Area of Science:

• Cardiology
• Medical Devices
• Electrophysiology

Background:

• Cardiac contractility modulation (CCM) is FDA-approved for heart failure patients lacking CRT indication.
• CCM improves heart failure hospitalizations, exercise tolerance, and quality of life.
• Limited data exist on CCM's impact on atrial fibrillation (AF) burden.

Observation:

• A 65-year-old male patient with a history of paroxysmal AF, hypertension, hyperlipidemia, and carotid artery stenosis presented with newly diagnosed ischemic cardiomyopathy (LVEF 20%-25%).
• Following coronary artery bypass graft surgery and guideline-directed medical therapy, his LVEF improved to 40%.
• Due to persistent heart failure symptoms and AF episodes, a CCM device and implantable loop recorder (ILR) were implanted.

Findings:

• Post-CCM device implantation, the patient's LVEF improved significantly to 60%.
• The implantable loop recorder monitoring revealed no instances of atrial fibrillation (AF).
• These results suggest a potential positive impact of CCM therapy on AF burden.

Implications:

• This case report suggests that CCM therapy may help manage or reduce atrial fibrillation burden in heart failure patients.
• Further research is warranted to elucidate the mechanisms by which CCM may influence AF.
• CCM therapy could represent a novel therapeutic approach for heart failure patients with co-existing AF.