If you want to say that the most laborious organ in the human body, the heart must be on the list. Relying on the rhythmic contraction and relaxation of the heart muscle, it beats continuously every day to transport blood throughout the body. Such a hard-working heart will sometimes “beat” and “beat too slow”, what should I do?
On May 13, the team of Director Yin Yongjun of the Cardiology Department of the Affiliated Hospital of Chengdu University of Traditional Chinese Medicine completed the first cardiac contractility regulator (CCM) implantation. CCM is an advanced heart failure treatment device. It implants stimulating electrodes into the patient’s ventricle through minimally invasive surgery, releases electrical stimulation during the absolute refractory period of the heart beat, and strengthens the cardiac contractility, thereby improving the cardiac function of patients with heart failure. It is mainly used for chronic heart failure patients with narrow QRS (<130 ms), poor drug treatment effect, and left ventricular ejection fraction of 25%-45%.
This is also the first hospital in China’s traditional Chinese medicine system to carry out this surgery.
Contractility Modulator (CCM)
The patient is a 49-year-old middle-aged Male, on May 3, was admitted to the hospital due to “wheezing, shortness of breath for 6+ months, and recurrence of aggravation for 4 days”. The patient frequently experienced paroxysmal pain in the precordial area. During the attack, he felt that the heart was squeezed and tightened. Each pain lasted for three to five minutes, and it improved after rest. The patient also had mild pitting edema in both lower extremities and was diagnosed as “Dilated cardiomyopathy”, cardiac function class III.
Echocardiography suggests that the patient’s whole heart is enlarged, especially the left heart, which reflects the “ejection fraction” (EF value), an indicator of cardiac function. EF can reflect the heart’s ability to eject blood or the efficiency of blood ejection.) It is significantly reduced, only 29%, while the EF value of normal people is above 50%. The patient’s left ventricular wall beat amplitude was significantly weakened, and the systolic function was reduced. That is, the patient’s cardiac contractility is severely degraded.
Yin Yongjun, director of the Cardiology Department of the Affiliated Hospital of Chengdu University of Traditional Chinese Medicine, conducted a comprehensive evaluation of the patient’s data and decided to perform CCM surgery for the patient.
ccm to be implanted in a patient
On May 13th, minimally invasive surgery was in progress Under hemp. CCM surgery requires the implantation of two electrodes in the right ventricle of the patient, with a distance of no less than 2 cm from each other.
Accurate placement of the two leads is particularly critical to this operation, and it is also a difficult point of the operation. Not only the lead parameters are required to meet the requirements, but also the position and spacing of the two leads must be taken into account. Director Yin Yongjun and Dr. Wu Zhou With rich operating experience and superb lead manipulation technology, two active pacing electrodes were implanted successively from the right side to the right ventricular septum.
Intraoperative testing showed that the electrodes were accurately implanted on the healthy myocardium, and both electrodes functioned normally without interfering with each other. The operation took 90 minutes and was successfully completed.
CCM can enhance myocardial contractility, improve symptoms of heart failure, and improve quality of life without increasing the burden on the heart by applying electrical stimulation during the absolute refractory period of the heartbeat. Postoperatively, the patient felt well and symptoms improved.
Yin Yongjun said that although the drug treatment of heart failure has made considerable progress in recent years, it is still difficult to fundamentally improve the prognosis of patients with heart failure, and there are still a considerable number of heart failure patients whose symptoms are not obvious. Relief, the quality of life is worrying. For such patients, cardiac contractility regulator is an original device therapy for patients with narrow QRS heart failure, which fills the current gap in the field of chronic heart failure device therapy in China, and improves the quality of life of patients by increasing myocardial contractility and improving symptoms. In the long-term, it is expected to further improve ventricular remodeling and provide more treatment options for patients with heart failure.
ccm implanted in the patient’s body
Red Star News reporter Yu Zunsu, photo courtesy of the interviewee
Edit Wang He