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
Purkinje fibers the nucleus causes Purkinje fibers to appear, on a slide, lighter and larger than their neighbors, arranged along the longitudinal direction (parallel to the cardiac vector). They are often binucleated cells. Heart rate is governed by many influences from the autonomic nervous system. The Purkinje fibres do not have any known role in setting heart rate unless the SA node is compromised. They are influenced by electrical discharge from the sinoatrial node. During the ventricular contraction portion of the cardiac cycle, the Purkinje fibres carry the contraction impulse from both the left and right bundle branch to the myocardium of