CCM Therapy for Heart Failure
What is CCM Therapy?
CCM stands for cardiac contractility modulation. It is a non-pharmacological treatment for moderate to severe heart failure involving a small implanted device that sends electrical pulses to the heart during the absolute refractory period.
This enhances the strength of heart muscle contractions to improve pumping capacity and cardiac output. CCM therapy aims to aid the heart’s pumping ability long-term without affecting rhythm or conducting impulses like a pacemaker. This procedure is not currently FDA approved for heart failure outside of clinical trials but several large-scale clinical trials are underway to further evaluate its effectiveness.
Who is a Candidate for CCM Therapy?
Eligibility for CCM therapy clinical trials may be considered for people who have not responded adequately to standard medical therapy and are ineligible for or decline CRT/ICD devices. In general, potential candidates for CCM therapy include people with the following conditions:
- Symptomatic heart failure
This means that you have symptoms of heart failure, such as shortness of breath, fatigue, and swelling in your legs. - Ejection fraction under 35%
This is a measure of how well your heart pumps blood. A normal ejection fraction is 50-70%. - Normal sinus rhythm
This means that your heart beats regularly. - No permanent pacemakers or ICD devices
These devices are used to treat other heart conditions, such as arrhythmias. If you have one of these devices, you may not be a candidate for CCM therapy.
CCM Implantation Procedure
The CCM device consists of a pulse generator and three ventricular electrode leads. The pulse generator is about the size of a hockey puck and is implanted under the skin of the chest. The ventricular electrode leads are thin wires that are threaded through the veins in the chest and attached to the heart muscle.
CCM implantation is performed under local anesthesia. The procedure takes about 2 hours and is usually done as an outpatient procedure. The surgeon will make a small incision in the chest and insert the pulse generator and electrode leads. The incision will be closed with stitches or staples.
After the procedure, you will be monitored in the hospital for a few hours. You may experience some pain and discomfort at the implant site. You will also be given instructions on how to care for the implant site.
Activation of the CCM device occurs several weeks after implantation. This is when the device is turned on and the settings are adjusted. You will need to see your doctor for a follow-up appointment to have the device activated. Here are some additional things to keep in mind about the CCM implantation procedure:
- You will need to take antibiotics before and after the procedure to prevent infection.
- You may experience some pain and discomfort at the implant site for a few days after the procedure.
- You will need to wear a compression vest for a few days after the procedure to help with healing.
- You will need to avoid strenuous activity for a few weeks after the procedure.
- You will need to see your doctor for regular follow-up appointments to monitor the device and ensure that it is working properly.
Causes and Symptoms of Condition
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