Impulse Dynamics Coordinates Cardiac Contractility Modulation (CCM) Certification Training Program

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German Cardiologists embrace CCM as therapeutic treatment for heart failure.

CCM is safe and shows in patients with narrow QRS complex results comparable to those of CRT therapy in wide QRS complex and thereby significantly improves the quality of life and exercise tolerance of these patients.

According to Impulse Dynamics, a growing number of cardiologists are employing Cardiac Contractility Modulation (CCM) to bolster their therapeutic armamentarium for patients with chronic heart failure. CCM leads to a long-term increase of cardiac contractility. At a meeting in Berlin, expert speakers addressed three of the underlying reasons for this development: (1) For large patient populations, CCM therapy is currently the only available device-based treatment alternative to pharmacologic management, (2) recent clinical results are consistently favorable, (3) the benefits are clearly corroborated by a completed clinical study as well as by additional trials in progress.

Approximately 35 cardiologists actively implanting CCM devices in Germany accepted the invitation to attend the CCM Certification Training Program for the Optimizer III system on January 13 and 14, the first such event in 2012. The participants concur with their colleagues at close to 60 heart centers in Germany that CCM offers significant therapeutic advances for the growing number of patients with advanced symptomatic heart failure and normal QRS duration. Experience shows that, while those patients are not candidates for the more common cardiac resynchronization therapy (CRT), CCM clearly improves their quality of life and increases their exercise tolerance in comparison to medical management alone.
PD Dr. Christian Butter, a pioneer and well known expert in the field of CCM therapy, hosted the event. He stated in his introductory talk about the mechanism of action behind CCM therapy: “The heart muscle is stimulated during the refractory period, a specific phase of the electrical cardiac cycle. Stimulation instantly improves myocardial calcium metabolism, thereby markedly increasing cardiac contractility without a concomitant increase of myocardial oxygen consumption. Over time, the fetal gene program of the myocardium reveres to the normal adult one. These changes are eventually capable of stopping or even reversing detrimental left ventricular remodeling processes.”

In addition to its direct effect, this type of treatment provides additional benefits to patients: Since implantation of the Optimizer III impulse generator is a minimal invasive procedure, the surgical risk is comparatively low. Other than devices such as pacemakers, implantable cardioverter defibrillators (ICD), and CRT systems, which require surgical battery replacement, CCM therapy offers the added advantage that this invasive procedure is not needed for many years: Patients recharge the battery – an integral part of the impulse generator – quite easily at home.

While in Germany alone, the number of implanted Optimizer systems is now approaching 1000, more and more new study results underline the efficacy and safety of CCM. The internationally renowned expert and principal investigator of several heart failure studies, Prof. Dr. W. T. Abraham from the Heart and Vascular Center at Ohio State University, explained in Berlin: "Cardiac contractility modulation has been studied in three randomized controlled trials. CCM is safe and shows in patients with narrow QRS complex results comparable to those of CRT therapy in wide QRS complex and thereby significantly improves the quality of life and exercise tolerance of these patients. Outstanding results were seen in patients with baseline left ventricular ejection fraction of more than 35%, as well as in those with lower ejection fractions." These results are particularly remarkable because until now, CCM had been primarily used in patients with severely impaired left ventricular function, i.e. an EF below 35%. Even patients with an EF clearly lower that 30% report significant and durable improvements of their exercise tolerance not attainable by other therapies.

One of the patients attending the program in Berlin, who over the years had undergone seven pacemaker implantations and one ICD implantation to stabilize his condition, remarked on the difference between living a full life and bare survival: “Only after I had the Optimizer implanted, I actually began to feel noticeably better,” he explained. The quality of life improvement was also underlined by another patient, whose mobility had been severely limited due to his heart failure and who, thanks to CCM, “can finally waltz again.”

About Impulse Dynamics 
Impulse Dynamics is a medical device company dedicated to offering innovative solutions for treatment of Chronic Heart Failure. The Optimizer III with CCM therapy is CE marked and is available in select excellence centers across Europe and Asia.

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Matthias Vogt
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