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Figure 3 (A) Acute effects of cardiac contractility modulating (CCM) signals on dP/dt_max in patients with heart failure. Average CCM effect (dashed line) was independent of QRS duration. (B) In patients with prolonged QRS duration, CCM effects were additive to those of biventricular pacing (BVP) (B) Reprinted from Pappone et al. (38) with permission from Excerpta Medica, Inc.