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 cycle is composed of myocytes which initiate their internal contractions without applying to external nerves—with the exception of changes in the heart rate due to metabolic demand. In an electrocardiogram, electrical systole initiates the atrial systole at the P wave deflection of a steady signal; and it starts contractions (systole) of the ventricles at the Q deflection of the QRS complex. (Completing the P wave represents the end of the "ventricular diastole" and the start of the "ventricular systole"—see cycle diagram). The cardiac cycle involves four major stages of activity: 1) "Isovolumic relaxation", 2) Inflow, 3) "Isovolumic contraction", 4) "Ejection". (See