Two-year outcomes of a cardiac microcurrent device in chronic heart failure: A first-in-human pilot study

IF 3.7 2区 医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS
Dragana B. Kosevic, Una Radak, Petar Vukovic, Jan D. Schmitto, Kersten Brandes, Peter Goettel, Hans-Dirk Duengen, Elvis Tahirovic, Marija Zdravkovic, Johannes Mueller, Faouzi Kallel, Marat Fudim, Stefan D. Anker, Jesus Eduardo Rame, Miodrag Peric
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引用次数: 0

Abstract

Aims

In heart failure patients, altered myocardial electrical fields linked to oedema may impair left ventricular function. While short-term use of implanted microcurrent generators (C-MIC) has shown promise, long-term effects remain unclear. This study assessed the safety and efficacy of C-MIC use beyond the initial 6 month pilot period.

Methods

Patients from the initial C-MIC pilot study who were alive at 6 months were screened for 2 year follow-up. The primary endpoint included rates of all-cause, cardiac- and device-related mortality, all-cause, cardiac and device related hospitalizations, along with adverse events, device malfunctions and exchanges. Secondary endpoints evaluated device performance via left ventricular ejection fraction (LVEF), 6 min walk distance, New York Heart Association (NYHA) class and SF-36 quality-of-life scores and the need for prolonged therapy.

Results

Of the 10 patients enrolled in the initial study, 7 were enrolled in follow-up (mean age 52.4 ± 7.6 years, NYHA Class III and mean LVEF 31.7 ± 3.7%). No device-related adverse events occurred. One non-cardiac, non-device related death was reported at 18 months. Improvement in LVEF of 11.60% [95% confidence interval (CI): 5.64–17.56, P < 0.001] from baseline to 6 months was maintained at 2 years post-C-MIC deactivation, with a sustained increase of 12.56% from baseline (95% CI: 4.67–20.45, P = 0.002). Similarly, the 6 min walk distance improved by 206.35 m at 6 months (95% CI: 161.32–251.39, P < 0.0001) and remained at 191 m above baseline at 2 years (95% CI: 131.83–250.99, P < 0.0001). Improvements in NYHA functional class and SF-36 quality-of-life scores observed at 6 months were also preserved throughout the 2 year follow-up. One patient required C-MIC reactivation.

Conclusions

Long-term use of the C-MIC device appears safe with sustained improvements in NYHA class, LVEF, 6 min walk distance and quality of life, supporting the long-term therapeutic potential of microcurrent therapy.

Abstract Image

心脏微电流装置治疗慢性心力衰竭的两年疗效:首次人体先导研究
目的:在心力衰竭患者中,与水肿相关的心肌电场改变可能损害左心室功能。虽然短期使用植入式微电流发生器(C-MIC)已显示出希望,但长期效果尚不清楚。本研究评估了C-MIC在最初6个月的试验期后使用的安全性和有效性。方法:从最初的C-MIC试点研究中筛选6个月时存活的患者进行2年随访。主要终点包括全因、心脏和器械相关的死亡率,全因、心脏和器械相关的住院率,以及不良事件、器械故障和更换。次要终点通过左室射血分数(LVEF)、6分钟步行距离、纽约心脏协会(NYHA)分级和SF-36生活质量评分以及延长治疗的需要来评估装置的性能。结果:纳入初始研究的10例患者中,7例纳入随访(平均年龄52.4±7.6岁,NYHA III级,平均LVEF 31.7±3.7%)。未发生与器械相关的不良事件。18个月时报告了一例非心脏、非器械相关死亡。LVEF改善11.60%[95%可信区间(CI): 5.64-17.56, P]结论:长期使用C-MIC装置是安全的,NYHA分级、LVEF、6分钟步行距离和生活质量持续改善,支持微电流治疗的长期治疗潜力。
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来源期刊
ESC Heart Failure
ESC Heart Failure Medicine-Cardiology and Cardiovascular Medicine
CiteScore
7.00
自引率
7.90%
发文量
461
审稿时长
12 weeks
期刊介绍: ESC Heart Failure is the open access journal of the Heart Failure Association of the European Society of Cardiology dedicated to the advancement of knowledge in the field of heart failure. The journal aims to improve the understanding, prevention, investigation and treatment of heart failure. Molecular and cellular biology, pathology, physiology, electrophysiology, pharmacology, as well as the clinical, social and population sciences all form part of the discipline that is heart failure. Accordingly, submission of manuscripts on basic, translational, clinical and population sciences is invited. Original contributions on nursing, care of the elderly, primary care, health economics and other specialist fields related to heart failure are also welcome, as are case reports that highlight interesting aspects of heart failure care and treatment.
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