Acute Effects of a Non Excitatory Cardial Stimulation

Acute Neurotrophic Effects of a Non Excitatory Cardial Stimulation by Optimizer III System in Patients With Heart Failure

Electric stimulation by cardial contractility modulation (CCM)to improve contractility and physical capacity

Inclusion Criteria:

• planned CCM Implantation
• systolic left ventricular dysfunction despite of adequate therapy of heart failure (NYHA II, III, IV)
• implanted pacemaker, defibrillator or pacemaker during CS intubation
• written informed consent
• open entryways

Exclusion Criteria:

• anemia Hemoglobin (HB)<8 mg/dl
• lying coronary sinus (CS) tube or CS being not able to intubate
• chronic atrial fibrillation or flutter
• mechanic tricuspid valve prothesis
• no access via subclavian vein
• patients with VVI pacemaker being stimulated 110%
• idiopathic hypertrophic cardiomyopathy, restrictive constrictive cardiomyopathy or heart failure because of known inflammatory or infiltrative illnesses or constrictive illness
• acute myocardial ischemia presented by angina pectoris or ECG changes under load
• patients being hospitalized because of heart failure during the last month and have to be treated with intravenous diuretics or inotropic substances
• acute coronary syndrome should not be implanted for at least 3 month
• patients with mechanic aortic or tricuspid valve
• patients after heart transplantation
• patients with clinical significant ectopy, defined by > 8.900 PVCs during 24 hours at beginning Holter monitoring
• patients after hypertensive crisis
• patients with acute renal failure
• Ejection Fraction (EF) > 35
• patients after left ventricular pacemaker electrode
• pregnant or breast feeding women
• patients with heart failure after sepsis