Cardiac contractility modulation, or CCMTM therapy, may be an option for people who aren’t adequately responding to heart failure medications.1
As heart failure progresses, the heart slowly weakens and is not able to pump with the force required to supply oxygen-rich blood to meet the body’s needs. Symptoms can make everyday activities, such as walking, challenging. They include breathlessness, fatigue, confusion and swelling in the legs. Most people are prescribed medications intended to slow the progression of the disease and manage their symptoms. As the condition progresses, these medications lose their effectiveness and the quality of life for people with heart failure continues to decline.
CCM therapy has been proven to be safe and effective in numerous clinical studies, including several randomized controlled trials, and the results have been published in more than 80 articles in leading medical journals.2
How It Works
The Optimizer device is similar in size to a pacemaker that is implanted during a minimally invasive procedure while the patient is under light sedation.
During the procedure, the device is implanted under the skin of the upper chest, along with electrical leads that are placed in the heart’s right ventricle through the veins (transcatheter).
After the procedure, the physician programs the delivery of CCM® therapy for each patient and activates the device. The implanted device then sends electrical pulses to the heart muscle for a total of five hours a day, in one-hour treatments separated by regular intervals.
From the comfort of home, the patient charges the device each week for one hour using an external charger. The Optimizer has been rigorously tested and it is expected to provide CCM® therapy for up to 15 years before requiring replacement.
Frequently Asked Questions
Consider these questions to see if CCM therapy may be right for you or a loved one:
- Have you been diagnosed with heart failure by a doctor?
- Are you taking medications prescribed by your doctor to help improve your heart failure symptoms?
- Despite taking your heart failure medications, do the symptoms of heart failure (breathlessness, fatigue, confusion, and swelling in the legs, etc.) prevent you from doing everyday things?
- Despite receiving any type of treatment (medications or device-based therapies, such as an implanted pacemaker or defibrillator), do you still wish to see your quality of life improve?
- Do you have an ejection fraction (a measurement of the heart’s pumping efficiency) of 25-45%?
If you answered "yes" to a majority of these questions, contact your cardiologist to schedule an appointment to discuss CCM therapy with a cardiologist at Marshall Cardiology.
In some ways yes, for example, both are implanted under the skin of the upper chest, and they each use leads to deliver therapy to the heart muscle. But that's where the similarities end.
Unlike a pacemaker or defibrillator, Optimizer® devices deliver CCM® therapy during the non-excitatory or absolute refractory period of the cardiac cycle. Instead of actually causing a contraction, CCM® therapy is designed to cause subsequent beats of the heart to be stronger or more forceful, which can result in more oxygen rich blood to be delivered to the body with each beat.
A pacemaker is used to treat slow heart rhythm disturbances which are symptomatic. Defibrillators can do that and can deliver lifesaving therapy when/if patients experience life-threatening electrical disturbances called arrhythmias. Cardiac contractility modulation is used to treat patients with heart failure to make their hearts beat stronger and make them feel better.
The therapy is covered by Medicare and is increasingly covered by commercial insurers.
1 Abraham WT, Kuck KH, Goldsmith RL, et al. A randomized controlled trial to evaluate the safety and efficacy of cardiac contractility modulation. JACC Heart Failure. 6(10), 874-883 (2018).
2 Clinical evidence on file: https://impulse-dynamics.com/providers/clinical-trials/
To schedule an appointment or for more information, call Marshall Cardiology at 304-691-8500.