Outcomes of Cardiac Contractility Modulation: A Systematic Review and Meta-Analysis of Randomized Clinical Trials
Joint Authors
Saad, Marwan
Mando, Ramy
Goel, Akshay
Habash, Fuad
Ayoub, Karam
Vallurupalli, Srikanth
Maskoun, Waddah
Source
Issue
Vol. 2019, Issue 2019 (31 Dec. 2019), pp.1-10, 10 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2019-06-17
Country of Publication
Egypt
No. of Pages
10
Main Subjects
Abstract EN
Background.
Cardiac contractility modulation (CCM) is a device therapy for systolic heart failure (HF) in patients with narrow QRS.
We aimed to perform an updated meta-analysis of the randomized clinical trials (RCTs) to assess the efficacy and safety of CCM therapy.
Methods.
We conducted a systematic review and meta-analysis of randomized clinical trials (RCTs) between January 2001 and June 2018.
Outcomes of interest were peak oxygen consumption (peak VO2), 6-Minute Walk Distance (6MWD), Minnesota Living with Heart Failure Questionnaire (MLHFQ), HF hospitalizations, cardiac arrhythmias, pacemaker/ICD malfunctioning, all-cause hospitalizations, and mortality.
Data were expressed as standardized mean difference (SMD) or odds ratio (OR).
Results.
Four RCTs including 801 patients (CCM n = 394) were available for analysis.
The mean age was 59.63 ± 0.84 years, mean ejection fraction was 29.14 ± 1.22%, and mean QRS duration was 106.23 ± 1.65 msec.
Mean follow-up duration was six months.
CCM was associated with improved MLWHFQ (SMD -0.69, p = 0.0008).
There were no differences in HF hospitalizations (OR 0.76, p = 0.12), 6MWD (SMD 0.67, p = 0.10), arrhythmias (OR 1.40, p = 0.14), pacemaker/ICD malfunction/sensing defect (OR 2.23, p = 0.06), all-cause hospitalizations (OR 0.73, p = 0.33), or all-cause mortality (OR 1.04, p = 0.92) between the CCM and non-CCM groups.
Conclusions.
Short-term treatment with CCM may improve MLFHQ without significant difference in 6MWD, arrhythmic events, HF hospitalizations, all-cause hospitalizations, and all-cause mortality.
There is a trend towards increased pacemaker/ICD device malfunction.
Larger RCTs might be needed to determine if the CCM therapy will be beneficial with longer follow-up.
American Psychological Association (APA)
Mando, Ramy& Goel, Akshay& Habash, Fuad& Saad, Marwan& Ayoub, Karam& Vallurupalli, Srikanth…[et al.]. 2019. Outcomes of Cardiac Contractility Modulation: A Systematic Review and Meta-Analysis of Randomized Clinical Trials. Cardiovascular Therapeutics،Vol. 2019, no. 2019, pp.1-10.
https://search.emarefa.net/detail/BIM-1129253
Modern Language Association (MLA)
Mando, Ramy…[et al.]. Outcomes of Cardiac Contractility Modulation: A Systematic Review and Meta-Analysis of Randomized Clinical Trials. Cardiovascular Therapeutics No. 2019 (2019), pp.1-10.
https://search.emarefa.net/detail/BIM-1129253
American Medical Association (AMA)
Mando, Ramy& Goel, Akshay& Habash, Fuad& Saad, Marwan& Ayoub, Karam& Vallurupalli, Srikanth…[et al.]. Outcomes of Cardiac Contractility Modulation: A Systematic Review and Meta-Analysis of Randomized Clinical Trials. Cardiovascular Therapeutics. 2019. Vol. 2019, no. 2019, pp.1-10.
https://search.emarefa.net/detail/BIM-1129253
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-1129253