In the longest follow-up to date of cardiac resynchronisation therapy (CRT) for mild heart failure patients, Boston Scientific’s multicentre automatic defibrillator implantation trial – cardiac resynchronisation therapy (MADIT-CRT) study demonstrated significant and sustained survival benefit for the indicated population.
The long-term results, presented at the American College of Cardiology’s 63rd Annual Scientific Session by Ilan Goldenberg, director of the department of cardiology at the Leviev Heart Center at Sheba Medical Center, Tel Hashomer, Israel, demonstrated a 41% relative reduction in the risk of death in patients with mild heart failure and left bundle branch block who received a Boston Scientific defibrillator with CRT therapy, compared to patients who received a defibrillator alone. Over 80% of patients who received CRT therapy were still alive at seven years. In addition to the mortality benefit, the results demonstrate that these patients experienced a 62% relative reduction in the risk of experiencing a first heart failure event when compared to patients who did not receive CRT therapy.
“Heart failure is a progressive disease that is associated with very high mortality rates, especially when the disease is advanced,” says Goldenberg. “Our findings from the extended follow-up of MADIT-CRT patients indicate for the first time that we can substantially improve long-term survival in this high-risk population by intervening with cardiac resynchronisation therapy early in the clinical course of the disease when the patient has only mild heart failure symptoms.”
The MADIT-CRT trial compares ICD to CRT-D therapy in patients with mild heart failure. The original study followed 1,820 patients for an average of 2.4 years and the positive results helped form the basis of expanded indications for patients with New York Heart Class I or II, QRS ≥ 130 milliseconds, left bundle branch block, and ejection fraction ≤ 30%. These long-term data reflect 1,691 of the original patients followed for an average for 5.6 years.