Cardiac Contractility Modulation (CCM, Optimizer System)

What is a device for cardiac contractility modulation (CCM)?
Cardiac contractility modulation is a therapy method for patients with a medium to severely limited pumping function of the heart. The principle is based on the delivery of electrical pulses that, in contrast to pacemaker systems, do not lead to a cardiac contraction because they are delivered during a particular phase of the heart cycle (called the absolute refractory period). CCM signals increase the pumping function of the heart due to the expression of certain proteins and thus improve the symptoms of heart failure, such as limited physical endurance.
Because of the relatively high power consumption, patients must charge the pulse generator on their own once a week. This is done at home with a device that is placed externally on the pulse generator (duration of the weekly charging session 40 to 60 min).

How are devices for cardiac contractility modulation implanted?
Devices for cardiac contractility modulation are implanted in a similar way as a pacemaker system or a defibrillator. The implantation is performed under local anesthesia and the additional administration of sedatives. The pulse generator is usually inserted on the right side of the chest below the clavicle into a tissue pocket under the skin or between the chest muscles. Two leads are advanced to the right ventricle through veins leading to the heart, and they are anchored at the septum of the heart with a screw mechanism. Additionally, a lead can be positioned in the area of the right atrium.
The follow-up of the CCM systems take place at fixed intervals (every 6 to 12 months) at our pacemaker outpatient department.