Abstract
Background
Cardiac contractility modulation (CCM) is a new device-based therapy for advanced
systolic heart failure with normal QRS duration and therefore not suitable for cardiac
resynchronization therapy (CRT). Left ventricular (LV) reverse remodeling was reported
in patients treated with CCM or CRT, however, the extent of response was not compared.
Methods
This observational study consisted of three groups of patients with symptomatic heart
failure and LV ejection fraction <35% despite optimal medical therapy. Group 1 included those received CCM with a QRS
duration <120 ms (n=33), Group 2 included those received CRT with a QRS duration of 120–150 ms (n=43), and Group 3 included those received CRT with a QRS duration >150 ms (n=56). LV end-systolic volume (LVESV) was measured at baseline and 3 months later.
Results
Age, gender, etiology of heart failure and baseline ejection fraction were comparable.
A significant LV reverse remodeling was observed in each group. The degree of LVESV
reduction was similar between Group 1 and Group 2 (−11.3±11.8 vs. −13.6±18.3%, p=0.833), however, it was greater in Group 3 (−25.0±18.0%, both p<0.01). By using the reduction ≥15%, the responder rate was not different between Group 1 (39%) and Group 2 (42%),
but significantly higher in Group 3 (68%) (χ2=9.514, p=0.009).
Conclusion
CCM exhibited a similar LV reverse remodeling response to CRT for patients with a
mildly prolonged QRS, though the effect was less strong when compared to CRT for patients
with a very wide QRS.
Keywords
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Article info
Publication history
Published online: February 13, 2012
Accepted:
January 21,
2012
Received in revised form:
January 13,
2012
Received:
October 25,
2011
Identification
Copyright
© 2012 Elsevier Ireland Ltd. Published by Elsevier Inc. All rights reserved.
