Long term impact of cardiac contractility modulation on QRS durationâ˜

•CCM can improve patient functional status, and its effect on QRS duration was unknown.•70 patients were treated with CCM for a mean follow-up of 2.8 years.•12-vector-ECG recordings were made at baseline and final follow-up visits.•Mean QRS duration was unchanged (112.0-112.9 ms, p = n.s.).•CCM halts chronic QRS widening that occurs in the natural history of heart failure.

Background and purposeCardiac contractility modulation (CCM) is an implantable device treatment for heart failure with reduced ejection fraction. CCM therapy improves patient functional status but its effect on intra-ventricular conduction remains unknown.Methods70 patients treated with CCM between 12/2002 and 5/2013 had 12-vector-ECG recordings made at baseline and final follow-up visits. QRS complex duration was measured at each time point.ResultsMean follow-up was 2.8 years. Mean QRS duration was unchanged from baseline (112.0 ms) to last follow up (112.9 ms, p = n.s.). These results are strikingly different from comparative published data of several studies with heart failure patients without CCM, consistently indicating an increase in QRS duration (6.0-23.4 ms) over a similar time period.ConclusionsCCM prevents chronic ventricular depolarization delay that occurs in heart failure and that is associated with poorer outcomes. This supports the safety of long-term CCM therapy and suggests a possible long-term benefit in maintaining QRS duration.