New Therapy for Heart Failure Patients ¡V CUHK Shares First Hand Experience Using Cardiac Contractility Modulation in Asia
Locally, heart failure is one of the top diseases leading to hospitalization. The mortality of heart failure is close to 50% within 3 years. Survivors of acute disease were also debilitated from symptoms of breathlessness and loss of working capacity.
Heart failure is caused by ischaemic heart disease, hypertension and valvular heart disease and various heart muscle diseases. A normal heart acts as a central pump to maintain the circulation so as to supply blood, oxygen and nutrient to different parts of the body including major organs. Heart failure patients have a weakening of the heart muscle¡¦s pumping function. In late stage heart failure, the heart enlarges progressively, making it more difficult to contract and pump blood effectively. Organ failure will develop. Conventional treatment includes medications to control symptoms and hopefully prevent disease progression. For the last 7 years, we have developed biventricular pacemaker therapy in a sub-selected group of heart failure patients to regulate the pumping action of the heart. However, there has been no effective treatment for directly enhancing the pumping force or contractility of the heart.
The Division of Cardiology of the Department of Medicine and Therapeutics of The Chinese University of Hong Kong has been, in close collaboration with the Hospital Authority, in the forefront of clinical research to develop new and effective therapies for heart failure for the past ten years. It has introduced a new technology to Hong Kong since July 2005 and remained the first and only centre in Asia to perform this new treatment. This new treatment, called ¡§Cardiac Contractility Modulation (CCM)¡¨, is to implant a device that delivers intermittent electrical impulse to increase the contractility of the heart during native muscle contraction. This device does not induce artificial pacing, but delivers a current in special periods of the heart contraction interval to augment the pumping function of the heart. CCM requires a simple operation to implant a device into the patient¡¦s body, a procedure very similar to pacemaker implantation. The device will deliver electrical impulse through 2 electrodes connected to the ventricle and deliver treatment at regular intervals for a total of 5 hours per day. A major technological breakthrough of CCM is that the battery inside the implanted CCM device is ¡§rechargeable¡¨ externally simply by placing a portable charger over the chest for about 2 hours every week which can be performed easily after some training, even at home. The ability to charge the CCM device externally allows the battery to last at least for 10 years. To date, nine patients have received CCM therapy. All of them had successful CCM device implantation and so far all reported an improvement of symptoms, a better quality of life and increase in exercise capacity (typically tested by the distance one can walk continuously over a period of 6 minutes walk). Apart from the improvement of pumping function of the heart, patients show a favourable decrease in heart size after CCM therapy for as short as 3 months. The clinical trial in Europe also reports significant improvement in the pumping function of the heart (i.e. left ventricular ejection fraction) as measured by cardiac ultrasound (echocardiography), and significant improvement in heart failure symptoms in 22 patients received CCM therapy. The data of the European study has been published in the European Heart Journal.
Currently we have introduced an active research programme to support this noble and promising therapy of CCM therapy for more in need patients in Hong Kong. With our dedicated effort to advance treatment for heart failure, we believe CCM therapy brings new hope to our patients.
The Division of Cardiology and Division of Neurology of the Department of Medicine & Therapeutics, CUHK will organise the ¡§International Symposium on Cardiovascular & Neurovascular Medicine, in conjunction with International Heart Failure Symposium ¡V Hong Kong 2006¡¨ on 24-26 February 2006 at the Hong Kong Convention and Exhibition Centre. This symposium aims to highlight the recent advances in the assessment and treatment of cardiovascular diseases and stroke. The largest of the kind ever held in Hong Kong, the international symposium brings together physicians and allied healthcare professionals involved in various heart diseases and stroke from China, South-East Asia, Europe and the USA to share views and experiences. More than 100 renowned faculty members and speakers have been invited, providing a strong platform for academic exchange and professional education in this landmark event.