MADIT-CRT Trial Summary: CRT in HF

madit crt trial heart failure
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