Figure 5.

Cardiac contractility modulation mechanism of action. (A) A pulse generator delivers high-voltage biphasic impulses directly to the right ventricle to enhance contractility. Over time, this alters the local biology of myocardium and eventually effects left ventricular reverse remodeling. (B) A representative example of pressure-volume loops from baseline (black) and after CCM (magenta), illustrating the increase in end-systolic elastance. CCM, cardiac contractility modulation; MLWHFQ, Minnesota Living With Heart Failure questionnaire; NYHA, New York Heart Association. Courtesy of Abraham et al¹² and Mohri et al.⁴³