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my name is cecilia linda im a professor at the kalinski university hospital and carolines institute of stockholm sweden well the background is that not all patients are indicated with cardiac resynchronization therapy so if your heart failure patient 30 percent will have broad qrs and might be indicated but the rest who do not improve sufficiently for medication actually have an alternative and thats called a contractility modulation so cardio contractility modulation looks like a pacemaker but its not because it delivers stimulatory sickness to the ventricular septum which does not lead to a paste beat but thus increase contractility so that has been shown to be a valuable therapy and heart failure would reduce ejection fraction and now we studied in heart failure with reserve detection fraction what this design was a pilot study which is open the patients are aware that they got the device theyre aware that they receive therapy and it was a multi-center study because we wanted
