ABSTRACT
Following a non-ST-elevation myocardial infarction (MI), a 68-year-old hypertensive, severely obese woman with 45% left ventricular ejection fraction underwent an implantable cardiac monitor (ICM) insertion. After 8 months, the ICM remotely transmitted multiple non-sustained ventricular tachycardia episodes. Symptomatic during these events, the patient underwent an invasive electrophysiologic stimulation, which induced ventricular arrhythmia. Subsequently, implantable cardioverter-defibrillator implantation was recommended. Continuous remote monitoring via an ICM detected critical arrhythmias in this post-MI patient, facilitating timely intervention.
ABSTRACT
Cardiac contractility modulation (CCM) currently represents an innovative therapeutic strategy to improve quality of life and reduce hospitalizations in patients with chronic heart failure with reduced ejection fraction. In contemporary practice, a substantial proportion of patients with heart failure unfortunately remains symptomatic despite guideline-recommended pharmacological therapy and implantation of cardiac resynchronization therapy (CRT) devices. Such patients represent possible candidates for the use of CCM therapy with the goal of improving symptoms, ventricular function and, ultimately, prognosis. In this case report, we describe, for the first time, the use of CCM therapy in a patient with non-obstructive hypertrophic cardiomyopathy and symptomatic chronic heart failure despite optimal medical therapy and CRT.