Combined Approach in the Management of Chronic Heart Failure: Implantation of a Subcutaneous Cardioverter-Defibrillator and a Cardiac Contractility Modulation Device (A Clinical Case)

Chronic heart failure (CHF) remains one of the leading causes of morbidity and mortality worldwide. Despite significant advances in pharmacological therapy, a substantial proportion of CHF patients continue to experience disease progression and remain at high risk of sudden cardiac death (SCD). Implantable cardiac devices play a central role in the comprehensive management of CHF, offering both prevention of life-threatening arrhythmias and improvement of the heart’s pump function. Among these, implantable cardioverter-defibrillators and cardiac contractility modulation (CCM) devices are of particular importance, as they target distinct pathophysiological mechanisms of heart failure.
This article presents a clinical case of a CHF patient with reduced left ventricular ejection fraction. As the first step, the patient underwent implantation of a subcutaneous implantable cardioverterdefibrillator (S-ICD). The postoperative period was uncomplicated. In the second stage, a CCM device was implanted, followed by S-ICD reprogramming to prevent oversensing of the CCM signal by the defibrillator (cross-talk testing). No interference or malfunction was observed between the two simultaneously functioning devices following the interventions.
Conclusion: The combination of a subcutaneous cardioverter-defibrillator and a CCM device represents a promising therapeutic strategy for patients with CHF. This clinical case demonstrates the feasibility of concurrent use of S-ICD and CCM devices for the prevention of sudden cardiac death episodes and improvement of quality of life.

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