was also the case for CRT therapy when it was first introduced, advocating the provision of cardiac contractility modulation to suitable patients before further studies are completed. To date (February 2015), there are at least two meta-analyses studying the efficacy of cardiac contractility modulation therapy on heart failure, a large number of review articles (e.g.) and at least two survey articles on device-based treatments of advanced heart failure which address cardiac contractility modulation. Furthermore, there are more than 70 individual publications focusing specifically on cardiac contractility modulation therapy. Further randomized controlled trials studying the effect of cardiac contractility modulation on the progression of heart failure have been initiated and are currently (as of February 2015) recruiting patients. Meta-analyses Giallauria et al. evaluated the three randomized controlled trials (RCTs) currently available on cardiac contractility modulation as a treatment for heart failure patients. The three trials included a total of 641 patients and assessed the effect of cardiac contractility modulation either in comparison to a sham treatment or in comparison to the best medical treatment. In contrast to an earlier meta-analysis by Kwong et al. the study did not evaluate the data based on summarized results alone, but on the basis of the individual data sets of the 641 enrolled patients. The study concluded that cardiac contractility modulation significantly improved important markers of cardiac performance. These included the maximal oxygen uptake (peak VO2 or pVO2 – measured by ventilatory parameters during a cardiopulmonary exercise test), which is indicative of improved survival, and the 6-minute walk test. The quality of life of participating patients, measured by the Minnesota Living with Heart Failure Questionnaire (MLWHFQ), also improved significantly. However, both meta-analyses demanded additional and larger randomized controlled trials in order to evaluate the effect of the therapy more precisely. Giallauria et al. describe the success of cardiac contractility modulation and the further potential of the therapy. Particular emphasis is given to the possibility that cardiac contractility modulation therapy may close the therapeutic gap in heart failure treatment if previous study outcomes are confirmed. Long-Term Survival Studies As of February 2015, the effect of cardiac contractility modulation therapy on the long-term mortality rates of heart failure patients has not been studied in a randomized controlled trial. Some preliminary single-center studies have been reported though. Kuschyk et al. evaluated the long-term efficacy and survival of patients with cardiac contractility modulation. Their analysis included 81 patients with