Cardiac contractility modulation by electric currents applied during the refractory period in patients with heart failure secondary to ischemic or idiopathic dilated cardiomyopathy

Carlo Pappone, Salvatore Rosanio, Daniel Burkhoff, Yuval Mika, Gabriele Vicedomini, Giuseppe Augello, Itzhak Shemer, David Prutchi, Walid Haddad, Ricardo Aviv, Yehuda Snir, Itzhak Kronzon, Ottavio Alfieri, Shlomo A. Ben-Haim

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Abstract

We assessed the feasibility of cardiac contractility modulation (CCM) by electric currents applied during the refractory period in patients with heart failure (HF). Extracellular electric currents modulating action potential and calcium transients have been shown to potentiate myocardial contractility in vitro and in animal models of chronic HF. CCM signals were biphasic square-wave pulses with adjustable amplitude, duration, and time delay from sensing of local electric activity. Signals were applied to the left ventricle through an epicardial vein (in 12 patients) or to the right ventricular (RV) aspect of the septum endocardially (in 6 patients). Simultaneous left ventricular (LV) and aortic pressure measurements were performed using a Millar catheter (Millar Instruments, Houston, Texas). Hemodynamics during RV temporary dual-chamber pacing was regarded as the control condition. Both LV and RV CCM stimulation increased dP/dtmax to a similar degree (9.1 ± 4.5% and 7.1 ± 0.8%, respectively; p max and a 17.0 ± 7.5% increase in pulse pressure compared with BVP alone (p

Original languageEnglish
Pages (from-to)1307-1313
Number of pages7
JournalThe American Journal of Cardiology
Volume90
Issue number12
DOIs
Publication statusPublished - Dec 15 2002

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ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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