First Human Implant With Cardiac Contractility Modulation in a Patient With an Extravascular Implantable...

Cardiac contractility modulation (CCM) improves myocardial contractility and heart failure (HF) symptoms, whereas the extravascular implantable cardioverter-defibrillator (EV-ICD) offers defibrillation without transvenous leads. Their combined use has not been previously reported.

This case presents the first documented implantation of CCM therapy in a patient with a prior EV-ICD. Lead placement and programming were optimized to prevent interference. Both devices functioned independently, with stable sensing and no inappropriate therapies. The patient experienced improved HF symptoms.

This case demonstrates the feasibility and safety of integrating CCM and EV-ICD therapy, highlighting the importance of strategic lead positioning and programming.

This is the first report of CCM and EV-ICD integration, demonstrating their complementary role in HF management.

CCM and EV-ICD can be safely combined, expanding options for HF patients requiring both therapies.