Background. Cardiac contractilitymodulation (CCM) is a device therapy for systolic heart failure (HF) in patientswith narrowQRS.\nWe aimed to perform an updated meta-analysis of the randomized clinical trials (RCTs) to assess the efficacy and safety of CCM\ntherapy. Methods. We conducted a systematic review and meta-analysis of randomized clinical trials (RCTs) between January 2001\nand June 2018. Outcomes of interest were peak oxygen consumption (peak VO2), 6-MinuteWalk Distance (6MWD), Minnesota\nLiving with Heart Failure Questionnaire (MLHFQ), HF hospitalizations, cardiac arrhythmias, pacemaker/ICD malfunctioning,\nall-cause hospitalizations, and mortality. Data were expressed as standardized mean difference (SMD) or odds ratio (OR). Results.\nFour RCTs including 801 patients (CCMn = 394) were available for analysis...................
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