Long term impact of cardiac contractility modulation on QRS duration

J Electrocardiol. 2014 Nov-Dec;47(6):936-40. doi: 10.1016/j.jelectrocard.2014.08.011. Epub 2014 Aug 14.

Abstract

Background and purpose: Cardiac contractility modulation (CCM) is an implantable device treatment for heart failure with reduced ejection fraction. CCM therapy improves patient functional status but its effect on intra-ventricular conduction remains unknown.

Methods: 70 patients treated with CCM between 12/2002 and 5/2013 had 12-vector-ECG recordings made at baseline and final follow-up visits. QRS complex duration was measured at each time point.

Results: Mean follow-up was 2.8 years. Mean QRS duration was unchanged from baseline (112.0 ms) to last follow up (112.9 ms, p=n.s.). These results are strikingly different from comparative published data of several studies with heart failure patients without CCM, consistently indicating an increase in QRS duration (6.0-23.4 ms) over a similar time period.

Conclusions: CCM prevents chronic ventricular depolarization delay that occurs in heart failure and that is associated with poorer outcomes. This supports the safety of long-term CCM therapy and suggests a possible long-term benefit in maintaining QRS duration.

Keywords: Cardiac contractility modulation; ECG; Heart failure.

Publication types

  • Clinical Trial

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Cardiac Pacing, Artificial / methods*
  • Female
  • Follow-Up Studies
  • Heart Failure / complications
  • Heart Failure / diagnosis*
  • Heart Failure / prevention & control*
  • Humans
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Treatment Outcome
  • Ventricular Dysfunction, Left / complications
  • Ventricular Dysfunction, Left / diagnosis*
  • Ventricular Dysfunction, Left / prevention & control*