Heart failure patients experience 46% reduction in atrial fibrillation risk with AdaptivCRT feature in CRT devices


On 23 September, Medtronic announced clinical trial results showing that heart failure patients treated with its AdaptivCRT feature experienced a 46% reduction in atrial fibrillation risk. The AdaptivCRT technology is a feature on certain cardiac resynchronisation therapy-defibrillators (CRT-Ds) that continually adjusts therapy to a patient’s natural heart rhythms and minimises the amount of unnecessary right ventricular pacing.

The results were presented at a late-breaking trial scientific session of the 17th Heart Failure Society of America meeting (HFSA, Orlando, USA, 22–25 September).

Because the AdaptivCRT technology utilises the heart’s natural rhythm to continuously adjust therapy, patients in the study who received AdaptivCRT experienced a 34% reduction in right ventricular pacing compared to conventional cardiac resynchronisation therapy. Long-term data showed that patients receiving the AdaptivCRT technology were at a 46% lower risk of spending 48 consecutive hours or more in atrial fibrillation compared to conventional cardiac resynchronisation therapy patients.

Earlier research showed that the use of the AdaptivCRT feature improves heart failure patients’ response rate to cardiac resynchronisation therapy, resulting in a projected 21% reduction in overall heart failure hospitalisations within the first year after implant, as compared to historical cardiac resynchronisation trials, the company reported. Results also reinforced the safety and effectiveness of the AdaptivCRT feature.

“The AdaptivCRT technology is a novel approach to CRT-D that continually and automatically adjusts the therapy to the heart rhythm for each individual patient,” said David Steinhaus, vice president and general manager, Heart Failure, and medical director for the Cardiac Rhythm Disease Managements business at Medtronic. “The results of the Adaptive CRT trial will be significant as the ‘baby boomer’ population ages and becomes more vulnerable to heart failure and associated conditions such as atrial fibrillation.”

The AdaptivCRT algorithm is included in the Medtronic Viva portfolio of CRT-D devices, which have been available in the United States since May 2013 and in Europe since 2012.

About the Adaptive CRT trial

The global Adaptive CRT trial is a prospective, multicentre, randomised, double-blind study designed to evaluate the clinical benefit of synchronised left ventricular pacing provided by the AdaptivCRT algorithm. The trial enrolled 522 patients who received a CRT device and were randomised to either receive the AdaptivCRT algorithm (treatment arm) or conventional CRT with echocardiographic optimisation of the pacing parameters (control arm) in a 2:1 ratio. All patients were followed at six and 12 months and subsequently every six months until study closure. Overall, the Adaptive CRT trial demonstrated non-inferiority of the AdaptivCRT algorithm to echocardiographically optimised cardiac resynchronisation therapy.