Heart failure & cardiomyopathies
Device-Therapy in Chronic Heart Failure: Cardiac Contractility Modulation Versus Cardiac Resynchronization Therapy
Authors' conclusion
Chronic heart failure patients could experience comparable 12-month improvements in functional status and ventricular reverse remodelling, with appropriately implanted CCMs and CRT-Ds.
Study context
- Population
- Patients with symptomatic heart failure (HF) and reduced left ventricular ejection fraction (LVEF) despite optimal medical treatment, implanted at one centre 2012–2021
- Participants
- 105 vs 220
- Exposure
- CCM vs CRT-D
- CCMn = 105
- CRT-Dn = 220reference
- Outcome
- NYHA class, LVEF, TAPSE, QRS-width and other HF modification aspects
- Follow-up
- 12 months
Methodological detailssingle-centre, registry-based, Retrospective analysis of MARACANA and MAINTAINED registries
- Single-centre
- Registry-based
- Retrospective analysis of MARACANA and MAINTAINED registries
Main finding
As reported in the abstract
- NYHA at follow-up, comparable improvement
- 2.43 ± 0.67 vs. 2.28 ± 0.72
- LVEF at follow-up (%), comparable improvement
- 30.5 ± 10.7 vs. 35.2 ± 10.5%
- Tricuspid annular plane systolic excursion (TAPSE) (mm), comparable improvement
- 17.2 ± 5.2 vs. 17.1 ± 4.8 to 18.9 ± 3.4 vs. 17.3 ± 3.6 mm
- Change from baseline, each
- P < 0.05
Observational data: associations, not effects.
Further findings
| Outcome | CRT-D | CCM | OR | P value |
|---|---|---|---|---|
| Baseline LVEF and NYHA · before implantation | ||||
| LVEF | 26.3 ± 6.5% | 23.6 ± 6.2% | ||
| NYHA | 2.81 ± 0.48 | 3.03 ± 0.47 | ||
| QRS-width, baseline vs 12 months | ||||
| Intrinsic QRS-width | — not stated in the abstract | 109.1 ± 18 vs. 111.7 ± 19.7 ms | ||
| Intrinsic baseline vs paced 12-month QRS-width | 157.5 ± 16.5 vs. 139.2 ± 16 ms | — not stated in the abstract | ||
| HF hospitalizations | 16.8%/patient years | 45.7%/patient years | 4.2 | P < 0.001 |
— not stated in the abstract
- Baseline LVEF and NYHA: both P < 0.05
- QRS-width, baseline vs 12 months: CCM P > 0.05
- QRS-width, baseline vs 12 months: CRT-D P < 0.05
Original publication
Device-Therapy in Chronic Heart Failure: Cardiac Contractility Modulation Versus Cardiac Resynchronization Therapy. ESC Heart Fail. Published 29 September 2024. doi:10.
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