Modern Implantable Cardiac Devices – The Key to Recoupling.pptx

1、Modern Implantable Cardiac Devices The Key to Recoupling?,James C.Fang,MDProfessor and ChiefUniversity of Utah School of MedicineSalt Lake City,UT,disclosures,AstraZenecaREALIZE-K(DSMB)Boerhinger-Ingelheim/LillyEMBRACE-HF(DSMB)AbbottabtMI study(CEC)Tikkunlev TherapeuticsSABCytokineticsCOMET-HF site

2、PI,WindtreeSEISMiC-HF(DSMB)SardocorMUSIC HFrEF trial(DSMB)NIHLeft vs Left Trial(CEC Chair)COMTEMP ICD(DSMB)AHADeputy Editor Circ Heart Fail,Cardiac contractility modulationoptimizer system impulse dynamics,“Indicated to improve 6-minute hall walk,quality of life,and functional status of NYHA III HF

3、patients who remain symptomatic despite GDMT,are not receiving CRT)and have a LVEF 25%-45%.”(2019),Cardiac modulation,Borggrefe and Burkhoff,EJHF 2012,CCM increases VO2 and QoLFIX-HF-5 Trial,Kadish A,et al.Am Heart J 2014;Giallauria F,et al.ESC HF 2020,Meta-analysis(n=861)4 randomized trials+single

4、arm extensionpeak V02+0.93 cc/kg/min(95%CI 0.56-1.30,P0.05)6MWT+17.97 m(95%CI 5.48-30.46,p0.05)MLWHFQ-7.85 points(95%CI(-)10.76-(-)4.94,p0.05),CCM-REGmortality benefit relative to predicted,Kuschyk J,et al.Eur J HF 2021,Baroreceptor stimulation therapy,Lindenfeld JA,et al.ESC 2019,“Indicated for pat

5、ients with HF who have symptoms despite being on GDMT with LVEF 35%,a NT-proBNP level of 1600 pg/mL,and NYHA II-III.The therapy is also not indicated for patients eligible for CRT.”(2019),Bat reduces MSNA and improves baroceptor sensitivity,Gronda E,et al.EJHF 2014,n=11,BAT in hfref improved NYHA,Qo

6、L,6mhwhope4hf trial,Abraham WT,et al.JACC-HF 2015,NT-proBNPp=0.02 HF Hospp=0.08,LVEF+4.3%,BeAT-HF trial24m clinical outcomes,QoL,Exercise,Zile MR,et al.Eur J HF 2024,NTproBNP 25%(743(477-1031)pg/ml),Hemodynamic comparisons of device therapiesacute hemodymamic benefits and clinical outcomes,?,?,Goals