New peer-reviewed research published in the Journal of Cardiac Failure offers promising real-world evidence on long-term survival after cardiac contractility modulation (CCM), a device-based therapy for patients with symptomatic heart failure who are not candidates for cardiac resynchronization therapy (CRT).
The study, led by Impulse Dynamics in collaboration with researchers at Saint Luke’s Mid America Heart Institute and the Cardiovascular Research Foundation, used electronic health record (EHR) data from Truveta to evaluate long-term survival outcomes after CCM implantation and to validate the use of real-world data for studying device therapies over time.
Addressing an evidence gap
CCM has been shown in randomized trials to improve exercise capacity and quality of life in patients with New York Heart Association (NYHA) class III heart failure with reduced ejection fraction. Despite these benefits, long-term survival outcomes after CCM therapy have remained less characterized.
This new analysis sought to address that gap by evaluating long-term survival after CCM implantation using a large, longitudinal real-world dataset. As part of the study design, they first looked at survival among patients who received CRT during the same period and compared those results with outcomes reported in the landmark CARE-HF randomized trial.
Alignment between real-world CRT survival and CARE-HF results supported using this approach to evaluate long-term outcomes in patients treated with CCM.
What the data show
Over the study period (January 2016 – December 2024), investigators identified 503 patients who received CCM therapy and examined all-cause mortality over approximately 1,000 days of follow-up using Kaplan–Meier survival estimates.
Key findings include:
- Survival after CCM implantation: Estimated survival at 1,000 days was 76.9%.
- Results within the FDA-approved CCM population: Among patients with baseline left ventricular ejection fraction (LVEF) within the FDA–approved range for CCM use (25%–45%), estimated survival at 1,000 days was similar to that observed in the overall CCM cohort.
- Consistency with prior CCM registry findings: Survival outcomes observed in this analysis were consistent with those reported in prior CCM registry studies over similar follow-up periods.
Together, these findings provide real-world context for long-term survival after CCM therapy and show how longitudinal EHR data can be used to study device outcomes over time.
Why it matters
Long-term survival is an important consideration when evaluating device-based therapies for heart failure, particularly for patients who are not candidates for established options such as CRT. By examining outcomes in routine clinical practice, this study adds real-world context to the existing evidence on cardiac contractility modulation.
The results show that survival after CCM implantation observed in real-world care aligns with prior registry data and that real-world analyses can reproduce benchmark outcomes for CRT. Together, these findings highlight how longitudinal data can support the study of device therapies over extended follow-up periods and across broader patient populations.
Read the full study in the Journal of Cardiac Failure to explore the methodology and findings in detail.