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Anaesthesia and cardiac contractility modulation

Published online by Cambridge University Press:  01 October 2007

G. Huschak ,
H. Schmidt-Runke  and
H. Rüffert
G. Huschak*
Affiliation:
University Hospital of Leipzig, Department of Anaesthesiology and Intensive Care Therapy, Leipzig, Germany
H. Schmidt-Runke
Affiliation:
University Hospital of Leipzig, Department of Anaesthesiology and Intensive Care Therapy, Leipzig, Germany
H. Rüffert
Affiliation:
University Hospital of Leipzig, Department of Anaesthesiology and Intensive Care Therapy, Leipzig, Germany
*
Correspondence to: Gerald Huschak, Klinik für Anaesthesiologie und Intensivtherapie Universität Leipzig, Liebigstraße 20, D-04103 Leipzig, Germany. E-mail:gerald.huschak@gmx.de; Tel: +49 (0)341 97 17700; Fax: +49 (0)341 97 17709
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Summary

Chronic heart failure is known to be an important risk factor for adverse perioperative outcome in patients undergoing non-cardiac surgery. A promising new form of electric therapy is currently being used in a phase III trial in patients with severe chronic heart failure (cardiac contractility modulation). Cardiac contractility modulation is a non-pharmacological approach to improve Ca2+ effect on cardiac myofilaments using electric currents. The cardiac contractility modulation system used at present (OPTIMIZER™ III, Impulse Dynamics, Orangeburg, NY, USA) consists of a subcutaneously implanted pulse generator and three electrodes. As far as we know, cardiac contractility modulation therapy is a safe and feasible way of improving the systolic function of the heart in congestive heart failure patients. No pro-arrhythmic effects of this new therapy have been reported. The technique shows promise as an additive treatment for severe chronic heart failure. The perioperative and intraoperative management of patients should follow current cardiac pacemaker/implantable cardioverter defibrillator guidelines.

Keywords

HEART FAILURE, CONGESTIVEMYOCARDIAL CONTRACTION, cardiac contractility modulationPACEMAKERS ARTIFICIAL
Type
Review
Information
European Journal of Anaesthesiology , Volume 24 , Issue 10 , October 2007 , pp. 819 - 825
Copyright
Copyright © European Society of Anaesthesiology 2007

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