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Research Article| Volume 183, P76-81, March 15, 2015

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Efficacy and survival in patients with cardiac contractility modulation: Long-term single center experience in 81 patients

  • Author Footnotes
    1 The authors take responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation. There is no acknowledgement of grant support to declare.
    Jürgen Kuschyk
    Correspondence
    Corresponding author at: University Medical Centre, I. Medical Department, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany.
    Footnotes
    1 The authors take responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation. There is no acknowledgement of grant support to declare.
    Affiliations
    University Medical Centre, I. Medical Department, Mannheim, Germany
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  • Author Footnotes
    1 The authors take responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation. There is no acknowledgement of grant support to declare.
    Susanne Roeger
    Footnotes
    1 The authors take responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation. There is no acknowledgement of grant support to declare.
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    University Medical Centre, I. Medical Department, Mannheim, Germany
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  • Author Footnotes
    1 The authors take responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation. There is no acknowledgement of grant support to declare.
    Raphaela Schneider
    Footnotes
    1 The authors take responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation. There is no acknowledgement of grant support to declare.
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    University Medical Centre, I. Medical Department, Mannheim, Germany
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  • Author Footnotes
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    Florian Streitner
    Footnotes
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    University Medical Centre, I. Medical Department, Mannheim, Germany
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    Ksenija Stach
    Footnotes
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    University Medical Centre, I. Medical Department, Mannheim, Germany
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    Boris Rudic
    Footnotes
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    University Medical Centre, I. Medical Department, Mannheim, Germany
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    Christel Weiß
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    University Medical Centre, Institute for Medical Statistics, Mannheim, Germany
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    Rainer Schimpf
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    Theano Papavasilliu
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    Benny Rousso
    Footnotes
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    IMPULSE Dynamics, Orangeburg, NY, USA
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    Daniel Burkhoff
    Footnotes
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    Columbia University, Cardiology, NY, USA
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    Martin Borggrefe
    Footnotes
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Published:January 20, 2015DOI:https://doi.org/10.1016/j.ijcard.2014.12.178
Efficacy and survival in patients with cardiac contractility modulation: Long-term single center experience in 81 patients
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      Abstract

      Aims

      To analyze long-term efficacy and survival in patients with chronic heart failure treated with cardiac contractility modulation.

      Methods

      81 patients implanted with a CCM device between 2004 and 2012 were included in this retrospective analysis. Changes in NYHA class, ejection fraction (EF), Minnesota Living with Heart Failure Questionnaire, NT-proBNP and peak VO2 were analyzed during a mean follow up of 34.2 ± 28 months (6–123 months). Observed mortality rate was compared with that predicted by the MAGGIC Score.

      Results

      Patients were 61 ± 12 years old with EF 23 ± 7%. Heart failure was due to ischemic (n = 48, 59.3%) or idiopathic dilated (n = 33, 40.7%) cardiomyopathy. EF increased from 23.1 ± 7.9 to 29.4 ± 8.6% (p < 0.05), mean NT-proBNP decreased from 4395 ± 3818 to 2762 ± 3490 ng/l (p < 0.05) and mean peak VO2 increased from 13.9 ± 3.3 to 14.6 ± 3.5 ml/kg/min (p = 0.1). The overall clinical responder rate (at least 1 class improvement of NYHA within 6 months or last follow-up) was 74.1%. 21 (25.9%) patients died during follow up, 11 (52.4%) due to cardiac conditions and 10 (47.6%) due to non-cardiac conditions. Mortality rates at 1 and 3 years were 5.2% and 29.5% compared to mortality rates estimated from the MAGGIC risk score of 18.4% (p < 0.001) and 40% (p = ns), respectively. Log-Rank analysis of all events through 3 years of follow-up, however, was significantly less than predicted (p = 0.022).

      Conclusions

      CCM therapy improved quality of life, exercise capacity, NYHA class, EF and NT-proBNP levels during long-term follow up. Mortality rates appeared to be lower than estimated from the MAGGIC score.

      Keywords

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      Article info

      Publication history

      Published online: January 20, 2015
      Accepted: December 23, 2014
      Received in revised form: November 27, 2014
      Received: January 25, 2014

      Identification

      DOI: https://doi.org/10.1016/j.ijcard.2014.12.178

      Copyright

      © 2015 Published by Elsevier Inc.

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