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Heart failure is a chronic condition in which the heart can’t pump blood as well as it should. About 50% of patients have heart failure with reduced ejection fraction (HFrEF), meaning the left ventricle pumps out less than 40% of the blood it contains with each contraction, causing debilitating symptoms such as:
- Feeling weak and tired
- Shortness of breath
- Trouble breathing when lying down
- Weight gain with swelling in the feet, legs, or ankles
Standard treatments such as diet changes, exercise, and medications such as diuretics, beta-blockers, Angiotensin-Converting-Enzyme inhibitors (ACE inhibitors), Mineralocorticoid Receptor Antagonist (MRAs), and Sodium-Glucose Cotransporter-2 Inhibitors (SGLT2 inhibitors) can slow disease progression. But for some patients, these treatments don’t relieve their symptoms—leaving them with few and drastic options.
For about one-third of patients, a pacemaker, or chronic resynchronization therapy, can help restore the heart’s regular contraction pattern. Other patients benefit from a left ventricle assist device (LVAD) to help the heart pump. While newer LVAD can be a long-term treatment and improve the quality of life for some patients, heart transplant surgery is often necessary.
The AccuCinch system provides structural support to the heart muscle. It improves the heart’s function by reducing the circumference of the ventricle—cinching it closed like the hood on a sweatshirt.
Changing the heart’s structure improves its efficiency, reducing symptoms of heart failure with reduced ejection fraction.
Changing the structure of the heart.
AccuCinch is designed for patients with heart failure with reduced ejection fraction for whom medications have been ineffective at reducing symptoms. The device is implanted using a transcatheter procedure.
With the patient asleep under anesthesia, the surgeon inserts a small tube through a large blood vessel, usually in the leg, to access the heart. Through this tube, the surgeon implants the AccuCinch device in the heart. This minimally invasive procedure means surgery is much less intense than traditional “open” procedures, so recovery times are significantly reduced.
Related reading: What is Congestive Heart Failure and How Can It Be Treated?
To achieve the “cinch” that can make the heart chamber almost a centimeter smaller, the surgeon places several anchors in a semicircle around the inner wall of the heart’s left ventricle. A solid but delicate string and a series of collars are threaded through the anchors. When the string is tightened, the heart muscle is pulled inward, much like the hood of a sweatshirt. This cinching motion pulls the heart muscle inward, reducing its circumference.
Early studies of the AccuCinch system have found that this device has significant benefits for patients with HFrEF, so we’ve tailored our research to learn all we can about these improvements.
The AccuCinch Ventricular Restoration System is a new, minimally invasive therapy for the millions of patients who suffer from heart failure with reduced ejection fraction.
Studying safety, effectiveness, and quality of life.
The CorCinch Trial is a randomized clinical trial enrolling 400 patients at 80 sites, including MedStar Health Research Institute at MedStar Washington Hospital Center. Participants have heart failure with an ejection fraction of 20% to 40%, and standard medicines have not relieved their symptoms.
Participants in the trial are randomly selected into two groups. One group receives the AccuCinch device; the other continues to take medicine. All participants are studied carefully for five years to determine whether the AccuCinch device is safe and effective.
To determine this, we’ll measure outcomes such as whether patients need a heart transplant or LVAD, whether they require hospitalization, and whether their quality of life improves.
Enrollment in the CorCinch Trial is ongoing. Not every patient with heart failure is a candidate for this study. Talk with your doctor or email research coordinator Megan Fuller to determine if you meet enrollment criteria.
For patients with heart failure, the condition can mean years spent feeling sick, going from doctor to doctor and hospital to hospital, seeking relief from debilitating symptoms.
We hope our research will demonstrate that the AccuCinch system helps reduce heart failure symptoms and improves the quality of life for our patients. We’re swinging for the fences, hoping to hit a home run to help them live longer and better.