Cardiac Contractility Modulation Therapy

Cardiac contractility modulation (CCM) therapy helps reduce the symptoms of heart failure. The therapy implants a small device in the chest. The device sends precisely timed electrical pulses to the heart to help it pump blood more effectively to relieve the symptoms of heart failure.

In contrast to a pacemaker or defibrillator, a CCM device changes the strength of heart muscle contractions rather than their rhythm. The CCM device consists of a pulse generator and three wires (leads) that connect to the heart. Pulses are delivered for five hours a day, in one-hour sessions separated by regular intervals.

Who Is It for?

Your cardiologist may recommend CCM therapy if:

• You have moderate to severe heart failure.
• Your heart failure symptoms make everyday activities difficult to perform.
• You have an ejection fraction (a measurement of the heart’s pumping efficiency) of 25 percent to 45 percent.

What to Expect Before, During and After the Procedure

Before the procedure

Your surgeon will provide you with specific instructions prior to your CCM device implantation surgery, discussing risks such as infection, bleeding and adverse reactions to anesthesia. Before your procedure, you’ll receive an IV with light sedation to keep you comfortable during the surgery.

During the procedure

Your doctor will make a small incision in the upper chest and insert the pulse generator and attach the leads to the heart’s right ventricle. The procedure takes about 2 hours and is typically done as an outpatient.

After the procedure

Your healthcare team will monitor you in the hospital for a few hours. You will be given instructions to care for the implant site before you leave the hospital.

You may feel some pain or discomfort at the incision site for a few days following the surgery. You may need to wear a compression vest for a few days to speed your healing. You’ll need to avoid strenuous activity for a few weeks following the surgery.

Your CCM device will not be activated until several weeks after implantation. You will see your doctor for a follow-up appointment to have your device activated and its settings adjusted.

Benefits of Cardiac Contractility Modulation Therapy

CCM can significantly relieve debilitating heart failure symptoms, including:

• Fatigue.
• Shortness of breath.
• Swelling in the legs.
• Dizziness.
• Confusion.

Risks and Potential Complications of Cardiac Contractility Modulation Therapy

Risks associated with CCM include:

• Risks related to surgery: These include bleeding, infection and discomfort.
• Electrical stimulation effects: Although the electrical signals delivered by a CCM device are generally painless and non-disruptive, some people may experience temporary discomfort or sensations.
• Differences in treatment response: Not everyone may experience the same degree of improvement in heart function or symptom relief.
• Long-term effectiveness: Because CCM therapy is relatively new, its long-term effectiveness and benefits are unknown and still being studied.

Follow-up Care

Your healthcare team will schedule regular follow-up appointments to check your device to make sure it’s functioning properly and adjust it as needed.