{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T20:06:48Z","timestamp":1781813208981,"version":"3.54.5"},"reference-count":36,"publisher":"Wiley","license":[{"start":{"date-parts":[[2019,6,17]],"date-time":"2019-06-17T00:00:00Z","timestamp":1560729600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cardiovascular Therapeutics"],"published-print":{"date-parts":[[2019,6,17]]},"abstract":"<jats:p><jats:italic>Background.<\/jats:italic> 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.<jats:italic> Methods<\/jats:italic>. 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).<jats:italic> Results<\/jats:italic>. Four RCTs including 801 patients (CCM n = 394) were available for analysis. The mean age was 59.63 \u00b1 0.84 years, mean ejection fraction was 29.14 \u00b1 1.22%, and mean QRS duration was 106.23 \u00b1 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.<jats:italic> Conclusions<\/jats:italic>. 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.<\/jats:p>","DOI":"10.1155\/2019\/9769724","type":"journal-article","created":{"date-parts":[[2019,6,17]],"date-time":"2019-06-17T19:32:00Z","timestamp":1560799920000},"page":"1-10","source":"Crossref","is-referenced-by-count":22,"title":["Outcomes of Cardiac Contractility Modulation: A Systematic Review and Meta-Analysis of Randomized Clinical Trials"],"prefix":"10.1155","volume":"2019","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2727-4648","authenticated-orcid":true,"given":"Ramy","family":"Mando","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Beaumont Health System, Royal Oak, MI, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akshay","family":"Goel","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, University of Arkansas for Medical Sciences, 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