Therapie der chronischen Herzinsuffizienz durch kardiale Kontraktionsmodulation (CCM)

Cardiac contractility modulation (CCM) is a device therapy for patients with systolic heart failure. CCM therapy applies non-excitatory signals during the absolute refractory period of the heart cycle. It influences myocardial contractility by modulating the regulation of calcium cycling. CCM therapy has been proven to enhance peak VO(2), quality of life and exercise tolerance in patients with congestive heart failure. It can be used as an additional therapy to an implantable cardioverter defibrillator (ICD), if present. CCM therapy should be considered in symptomatic patients with congestive heart failure, a left ventricular ejection fraction ≤35% and NYHA class?II-III. Atrial fibrillation, high grade arrhythmias and an AV block of more than 300?ms represent contraindications. Patients with a left bundle branch block of >120?ms should be considered for the implantation of a biventricular ICD prior to implantation of a CCM device.