Cardiac contractility modulation for heart failure, such as pacemaker therapy or implantable cardioverter defibrillators (ICD), Cardiac contractility modulation does not affect the cardiac rhythm directly. Rather, the aim is to enhance the heart’s natural contraction (the native cardiac contractility) sustainably over long periods of time. Furthermore, unlike most interventions that increase cardiac contractility, the Cardiac contractility modulation is not associated with an unfavorable increase in oxygen demand by the heart (measured in terms of Myocardial Oxygen Consumption or MVO). This may be explained by the beneficial effect the therapy has in improving cardiac efficiency. A meta-analysis in 2014 and an overview of device-based
Cardiac function curve activity of the sympathetic nerves, and a decrease in vagal tone cause the heart to beat more frequently and more forcefully. This alters the cardiac function curve, shifting it upwards. This allows the heart to cope with the required cardiac output at a relatively low right atrial pressure. We get what is known as a family of cardiac function curves, as the heart rate increases before the plateau is reached, and without the RAP having to rise dramatically to stretch the heart more and get the Starling effect. In vivo sympathetic outflow within the myocardium is probably best described by