photo: heart model
Patients who had a CRT-D have
better chances of survival; © SXC

The overall benefit observed from resynchronization therapy was driven by a 41 percent reduction in heart failure. Women who received a cardiac resynchronization device combined with a defibrillator (CRT-D) had an "astonishing" 63 percent reduction in their risk of heart failure.

In 2002, Arthur Moss, M.D., professor of Medicine at the University of Rochester Medical Center, and the MADIT (Multicenter Automatic Defibrillator Implantation Trial) research group showed that an implanted defibrillator, or ICD, reduced the risk of death by 31 percent in cardiac patients as part of the MADIT-II trial. This therapy was soon approved by the U.S. Food and Drug Administration. Long-term follow-up studies showed, however, that ICDs were so effective at preventing sudden death that patients lived longer and were subsequently at increased risk for heart failure. This created an urgent need to better address both risks in tandem.

Cardiac resynchronization therapy (CRT) is currently approved for treatment only for patients with symptoms of severe heart failure in whom it reduces symptoms by improving the mechanical pumping action of the heart. Moss, also principal investigator of the current MADIT-CRT trial, and his team designed MADIT-CRT as follow-up to MADIT-II. The new trial sought to determine if preventive CRT-D therapy, the combination of an ICD with CRT, could reduce the risk of mortality and heart failure in patients with mild cardiac disease and few symptoms (NYHA class I or II).

Over a 4½ year period, 1820 patients from 110 medical centers in the United States, Canada, and Europe were enrolled and followed in MADIT-CRT. "The findings from MADIT-CRT show that CRT-D effectively reduces the risk of heart failure," Moss said.

COMPAMED.de; Source: University of Rochester Medical Center