A novel device therapy for the treatment of moderate-to-severe chronic heart failure that does not respond to medicines or other corrective measures, termed Cardiac Contractility Modulation (CCM) Therapy, has become the lifeline for Harishankar, from whom life had been slipping away following severe heart failure.
CCM therapy, a treatment modality that had gained popularity in Europe, could be a new option for those with severe heart failure and for whom a heart transplantation might be the last resort for survival, C. Bharath Chandran, well-known interventional cardiologist, said at a press conference here on Saturday.
Harishankar, a 50-year-old advocate in the city, was the first recipient of CCM therapy in the country, he claimed. The procedure was done by Dr. Bharath Chandran at Sree Uthradom Thirunal Royal Hospital here on December 12, and the patient, who had been in a sinking stage, showed remarkable recovery hence, with improved ejection fraction, he said.
Heart failure is a chronic, progressive condition wherein the heart muscle is unable to pump enough blood for the body’s requirements. Heart function deteriorates steadily due to the progressive reduction in the contractility (pumping action) of the heart. CCM is an electrical impulse therapy similar to the functioning of a pacemaker. It has been developed by Impulse Dynamics, a medical devices firm in Germany and is being brought to India by Champak Enterprises in Bangalore.
When electrical impulses are continuously applied to two selected points on the right ventricle during the heart’s absolute refractory periods, it triggers a cascade of physiological changes at the cellular level, improving the cardiomyocyte structure and functioning.
An impulse generator device, the size of a pacemaker, is implanted in a pocket made on the chest below the collar bone of the patient. The procedure is done in the Cath lab under local anaesthesia.
The electrodes from the device, through which the electric impulses are sent is fixed on the walls of the right ventricle. The impulse generator monitors the cardiac impulse from the heart and delivers high energy electric impulses continuously during the absolute refractory periods.
The device has to be charged externally every 10 days. The cost of CCM therapy comes close to ₹35 lakh. However, CCM therapy has been proven to be effective in patients with heart failure due to left ventricular systolic dysfunction for whom newer medicines or procedures such as cardiac resynchronisation therapy does not work.
It was an alternative to heart transplantation, which has its associated risks and has been proven to improve longevity in heart failure patients, Dr. Bharath Chandran said.
