2009
MADIT-CRT TRIAL
Cardiac-Resynchronization Therapy for the prevention of heart-failure events
multicenter, open-label, randomized controlled trial
Objective: To determine whether cardiac-resynchronization therapy with implantable cardioverter-defibrillator (CRT-ICD) would reduce the risk of death or heart-failure events in
M
patients with mild cardiac symptoms, reduced ejection fraction, and wide QRS complex.
1820
patients
Inclusion criteria: Patients aged ≥21 years with Ischemic cardiomyopathy (NYHA class I or II) or nonischemic cardiomyopathy (NYHA class II only); Sinus rhythm; Ejection fraction < 30% and prolonged intraventricular conduction with QRS duration ≥130 msec
VS
CRT-ICD group (n=1087)
ICD-only group (n=731)
17.2
PRIMARY OUTCOME
Death from any cause or a nonfatal heart-failure event%
HR 0.66; 95% CI, 0.52 to 0.84; P=0.001
SECONDARY OUTCOMES
25.3
6.8
Death at any time %
7.3
HR 0.59; 95% CI, 0.47 to 0.74; P<0.001
0.11
Change in left ventricular ejection fraction P<0.001
0.03
Conclusion: CRT combined with ICD decreased the risk of heart-failure events in relatively asymptomatic patients with a low ejection fraction and wide QRS complex.
Moss AJ et al. NEJM 2009; 361:1329-1338
