**7. DCMP vs. CLC- DCMP — Clinical implications**

This special kind of "electrical tissue engineering" of the LDM in situ 14 days before wrapping the LDM around the heart and a controlled electrical stimulation pattern with a reduced mean pulse frequency minor 1Hz should significantly increase the clinical efficacy of DCMP which has been described above. The new pre-stimulated, controlled cardiomyoplasty (CLC-CMP) or its combination with intra-myocardial injections of adult stem cells (Stem Cell Cardiomyo‐ pexy) might open new fields in the therapy of pharmacologically untreatable heart failure.

Comparing DCMP vs. CLC- DCMP, the expected efficacy of CLC- DCMP, well based on facts as shown above, should become an effective and reliable treatment option for end-stage heart failure with much better therapeutic results as shown in clinical DCMP up to now. A combi‐ nation with an intramyocardial stem cell therapy is desirable [154], [155].

**Figure 24.** Pre-stimulated and such hypercapillarized muscle, wrapped around the heart for indirect revascularization and girdling using a stimulation with a reduced number of pulses as a controlled cardiomyoplasty (CLC-DCMP).
