Cardiac Contractility Modulation Therapy and Device Algorithm–related Challenges

Heart failure (HF) is a complex and potentially life-threatening medical condition posing significant risks to individuals. It is associated with substantial health care expenditures, considerable morbidity and mortality, and a decline in functional capacity and quality of life. Cardiac contractility modulation (CCM) has emerged as a promising device-based treatment for patients with HF with reduced ejection fraction (HFrEF). Studies have shown that CCM treatment in HFrEF patients can improve exercise tolerance and quality of life and reduce HF hospitalizations. As CCM therapy becomes a more prevalent treatment for HFrEF, the natural learning curve inherent in the use of new technologies necessitates broader provider training and careful patient follow-up. To that end, this article highlights the importance of developing a fundamental troubleshooting algorithm to help optimize the management of patients who have an implanted CCM device.