MADIT-CRT Long Term Follow-up

Multicenter Automatic Defibrillator Implantation Trial Cardiac Resynchronization Therapy (MADIT-CRT)

Status: Ongoing

The Boston Scientific sponsored MADIT CRT Long-Term Follow-Up results were presented March 30th, 2014 during the Late Breaking session at the American College of Cardiology meeting in Washington DC, and published online in the New England Journal of Medicine.

Patient Population

MADIT-CRT enrolled 1820 patients with an ejection fraction ≤ 30%, QRS ≥ 130 msec, and NYHA I/II.  Patients were randomized to Boston Scientific CRT-D vs. ICD-only and were followed over an average of 2.4 yrs.  A subset of 1691 MADIT-CRT patients from the original study cohort were included in the long-term follow-up study and followed through September 30, 2013 for an average follow-up 5.6 years

Results

In the MADIT CRT Long-Term Follow-Up study, patients with left bundle branch block (LBBB) who received a CRT-D demonstrated a significant and sustained survival benefit and had a reduction in first heart failure events compared to patients who received an ICD.

  • The relative risk of mortality was reduced by 41% in LBBB patients who received CRT-D compared to ICD
  • This mortality reduction corresponds to a number needed to treat (NNT) of 9; or 1 life saved over 7 years for every 9 patients who receive a CRT-D
  • Over 80% of patients who received CRT therapy were still alive at 7 years
  • CRT-D patients had a 62% reduction in the relative risk of a first heart failure event compared to patients who did not receive CRT 

Summary

  • Early intervention in indicated patients can reduce death and increase the life span of patients
  • Boston Scientific has responded to longer patient survival by developing CRT defibrillators with the longest projected battery longevity in the industry (LongLasting)
  • The longer lasting CRT-D devices from Boston Scientific can reduce the need for procedures in patients with heart failure, and ultimately reduce health care costs and device infections

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