{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,2]],"date-time":"2026-04-02T01:32:57Z","timestamp":1775093577019,"version":"3.50.1"},"reference-count":22,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2019,4,29]],"date-time":"2019-04-29T00:00:00Z","timestamp":1556496000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>(1) Background: Heart failure (HF) is a major cause of morbidity and mortality throughout the world. Despite substantial progress in its prevention and treatment, mortality rates remain high. Device therapy for HF mainly includes cardiac resynchronization therapy (CRT) and the use of an implantable cardioverter-defibrillator (ICD). Recently, however, a new device therapy\u2014cardiac contractility modulation (CCM)\u2014became available. (2) Aim: The purpose of this study is to present a first case-series of patients with different clinical patterns of HF with a reduced ejection fraction (HFrEF), supported with the newest generation of CCM devices. (3) Methods and results: Five patients with a left ventricular ejection fraction (LVEF) \u2264 35% and a New York Heart Association (NYHA) class \u2265 III were supported with CCM OPTIMIZER\u00ae SMART IPGCCMX10 at our clinic. The patients had a median age of 67 \u00b1 8.03 years (47\u201380) and were all males\u2014four with ischemic etiology dilated cardiomyopathy. In two cases, CCM was added on top of CRT (non-responders), and, in one patient, CCM was delivered during persistent atrial fibrillation (AF). After 6 months of follow-up, the LVEF increased from 25.4 \u00b1 6.8% to 27 \u00b1 9%, and the six-minute walk distance increased from 310 \u00b1 65.1 m to 466 \u00b1 23.6 m. One patient died 47 days after device implantation. (4) Conclusion: CCM therapy provided with the new model OPTIMIZER\u00ae SMART IPG CCMX10 is safe, feasible, and applicable to a wide range of patients with HF.<\/jats:p>","DOI":"10.3390\/jcm8050588","type":"journal-article","created":{"date-parts":[[2019,4,29]],"date-time":"2019-04-29T03:25:38Z","timestamp":1556508338000},"page":"588","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["New Generation Cardiac Contractility Modulation Device\u2014Filling the Gap in Heart Failure Treatment"],"prefix":"10.3390","volume":"8","author":[{"given":"Diana","family":"Tint","sequence":"first","affiliation":[{"name":"Faculty of Medicine, Transilvania University &amp; ICCO Clinics, Bd. Eroilor nr.29, 500036 Brasov, Romania"},{"name":"Sorin Micu, ICCO Clinics, Str. Scolii nr.8, 500059 Brasov, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roxana","family":"Florea","sequence":"additional","affiliation":[{"name":"Department of Neuroscience, Physiology and Pharmacology, University College London, London WC1E 6BT, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sorin","family":"Micu","sequence":"additional","affiliation":[{"name":"Sorin Micu, ICCO Clinics, Str. Scolii nr.8, 500059 Brasov, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2019,4,29]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"7","DOI":"10.15420\/cfr.2016:25:2","article-title":"Global Public Health Burden of Heart Failure","volume":"3","author":"Savarese","year":"2017","journal-title":"Card. Fail. Rev."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"877","DOI":"10.1056\/NEJMoa013474","article-title":"Multicenter Automatic Defibrillator Implantation Trial II Investigators. Prophylactic implantation of a defibrillator in patients with myocardial infarction and reduced ejection fraction","volume":"346","author":"Moss","year":"2002","journal-title":"New Engl. J. Med."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1056\/NEJMoa043399","article-title":"Sudden Cardiac Death in Heart Failure Trial (SCD-HeFT) Investigators. Sudden Cardiac Death in Heart Failure Trial (SCD-HeFT) Investigators. Amiodarone or an implantable cardioverter-defibrillator for congestive heart failure","volume":"352","author":"Bardy","year":"2005","journal-title":"New Engl. J. Med."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"2140","DOI":"10.1056\/NEJMoa032423","article-title":"Comparison of Medical Therapy, Pacing, and Defibrillation in Heart Failure (COMPANION) Investigators. Cardiac-resynchronization therapy with or without an implantable defibrillator in advanced chronic heart failure","volume":"350","author":"Bristow","year":"2004","journal-title":"New Engl. J. Med."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1539","DOI":"10.1056\/NEJMoa050496","article-title":"The Effect of Cardiac Resynchronization on Morbidity and Mortality in Heart Failure","volume":"352","author":"Cleland","year":"2005","journal-title":"New Engl. J. Med."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"891","DOI":"10.1002\/ejhf.592","article-title":"2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC). Developed with the special contribution of the Heart Failure Association (HFA) of the ESC","volume":"18","author":"Ponikowski","year":"2016","journal-title":"Eur. J. Heart Fail."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"529","DOI":"10.1093\/eurheartj\/ehs305","article-title":"Prevalence, correlates, and prognostic significance of QRS prolongation in heart failure with reduced and preserved ejection fraction","volume":"34","author":"Lund","year":"2013","journal-title":"Eur. Heart J. Fail."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"S3","DOI":"10.1016\/j.hrthm.2012.04.026","article-title":"Cardiac resynchronization therapy (CRT): Clinical trials, guidelines, and target populations","volume":"9","author":"Linde","year":"2012","journal-title":"Hear. Rhythm."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1270","DOI":"10.1093\/eurheartj\/ehi826","article-title":"Selecting patients for cardiac resynchronization therapy: electrical or mechanical dyssynchrony?","volume":"27","author":"Hawkins","year":"2006","journal-title":"Eur. Hear. J."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1097\/01.hco.0000198983.93755.99","article-title":"The problem of non-response to cardiac resynchronization therapy","volume":"21","author":"Birnie","year":"2006","journal-title":"Curr. Opin. Cardiol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"584","DOI":"10.1038\/nrcardio.2013.114","article-title":"Cardiac contractility modulation therapy in advanced systolic heart failure","volume":"10","author":"Lyon","year":"2013","journal-title":"Nat. Rev. Cardiol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1784","DOI":"10.1016\/j.jacc.2008.01.036","article-title":"Cardiac Contractility Modulation Electrical Signals Improve Myocardial Gene Expression in Patients With Heart Failure","volume":"51","author":"Butter","year":"2008","journal-title":"J. Am. Cardiol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1111\/j.1752-8062.2009.00097.x","article-title":"Ca(2+)-binding proteins in dogs with heart failure: effects of cardiac contractility modulation electrical signals","volume":"2","author":"Gupta","year":"2009","journal-title":"Clin. Transl. Sci."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1016\/0167-4889(96)00097-3","article-title":"Altered expression of the Ca(2+)-binding protein S100A1 in human cardiomyopathy","volume":"1313","author":"Remppis","year":"1996","journal-title":"Biochim. Biophys. Acta."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"650","DOI":"10.1016\/j.ehj.2004.02.027","article-title":"Chronic electrical stimulation during the absolute refractory period of the myocardium improves severe heart failure","volume":"25","author":"Stix","year":"2004","journal-title":"Eur. Hear. J."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1019","DOI":"10.1093\/eurheartj\/ehn020","article-title":"Randomized, double blind study of non-excitatory, cardiac contractility modulation electrical impulses for symptomatic heart failure","volume":"29","author":"Borggrefe","year":"2008","journal-title":"Eur. Hear. J."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"329","DOI":"10.1016\/j.ahj.2010.10.025","article-title":"A randomized controlled trial evaluating the safety and efficacy of cardiac contractility modulation in advanced heart failure","volume":"161","author":"Kadish","year":"2011","journal-title":"Am. Hear. J."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1016\/j.cardfail.2014.09.011","article-title":"A randomized controlled trial to evaluate the efficacy and safety of cardiac contractility modulation in patients with moderately reduced left ventricular ejection fraction and a narrow QRs duration: study rationale and design","volume":"21","author":"Abraham","year":"2015","journal-title":"J. Card. Fail."},{"key":"ref_19","first-page":"874","article-title":"A Randomized Controlled Trial to Evaluate the Safety and Efficacy of Cardiac Contractility Modulation","volume":"6","author":"Abraham","year":"2018","journal-title":"JACC: Hear. Fail."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1375","DOI":"10.1093\/europace\/eun257","article-title":"Cardiac contractility modulation in non-responders to cardiac resynchronization therapy","volume":"10","author":"Behrens","year":"2008","journal-title":"Europace"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1016\/j.ijcard.2018.10.086","article-title":"Cardiac contractility modulation treatment in patients with symptomatic heart failure despite optimal medical therapy and cardiac resynchronization therapy (CRT)","volume":"277","author":"Kuschyk","year":"2019","journal-title":"Int. J. Cardiol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1205","DOI":"10.1093\/europace\/euu050","article-title":"Cardiac contractility modulation: first experience in heart failure patients with reduced ejection fraction and permanent atrial fibrillation","volume":"16","author":"Schneider","year":"2014","journal-title":"Europace"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/8\/5\/588\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T12:47:54Z","timestamp":1760186874000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/8\/5\/588"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,4,29]]},"references-count":22,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2019,5]]}},"alternative-id":["jcm8050588"],"URL":"https:\/\/doi.org\/10.3390\/jcm8050588","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,4,29]]}}}