{"id":4573,"date":"2010-11-14T09:13:20","date_gmt":"2010-11-14T14:13:20","guid":{"rendered":"http:\/\/blogs.nejm.org\/cardioexchange\/?p=4573"},"modified":"2011-07-19T17:44:43","modified_gmt":"2011-07-19T21:44:43","slug":"icd-crt-found-beneficial-in-raft","status":"publish","type":"post","link":"https:\/\/blogs.nejm.org\/cardioexchange\/2010\/11\/14\/icd-crt-found-beneficial-in-raft\/","title":{"rendered":"ICD-CRT Found Beneficial in RAFT"},"content":{"rendered":"<p>RAFT (Resynchronization-Defibrillation for Ambulatory Heart Failure Trial) randomized 1798 patients with NYHA class II or III heart failure, LVEF <span style=\"text-decoration: underline;\">&lt;<\/span> 30%, and a wide QRS complex to either an ICD alone or an ICD-CRT. After a mean followup of 40 months, the rate of death or heart failure hospitalization was 40.3% in the ICD group compared to 33.2% in the ICD-CRT group (p&lt;0.001) and overall mortality rates were 26.1% and 20.8%, respectively (p&lt;0.003). There were more adverse events in the ICD-CRT group, however (124 versus 58 in the placebo group at 30 days). As in t<a href=\"http:\/\/www.nejm.org\/doi\/pdf\/10.1056\/NEJMoa0906431\">he MADIT-CRT trial<\/a>, an increased benefit was observed in patients with QRS durations of 150 msec or more.<\/p>\n<p>RAFT was\u00a0presented at the AHA meeting in Chicago and <a href=\"http:\/\/www.nejm.org\/doi\/full\/10.1056\/NEJMoa1009540\">published online simultaneously in the <\/a><em><a href=\"http:\/\/www.nejm.org\/doi\/full\/10.1056\/NEJMoa1009540\">New England Journal of Medicine<\/a>. <\/em>Speculating about why RAFT, unlike MADIT-CRT, was able to show a survival benefit, the RAFT investigators pointed out that RAFT patients were sicker than their MADIT-CRT counterparts and underwent a longer and more complete followup.<\/p>\n<p>In <a href=\"http:\/\/www.nejm.org\/doi\/full\/10.1056\/NEJMe1011742\">an accompanying editorial<\/a>, Arthur Moss writes that three trials (MADIT-CRT, RAFT, and REVERSE) now provide &#8220;convincing evidence of the therapeutic prowess of CRT in appropriately selected patients with ischemic or nonischemic cardiomyopathy.&#8221;<\/p>\n<p>Note: In <a href=\"http:\/\/blogs.nejm.org\/cardioexchange\/a-life-raft-for-patients-with-hf\/\">an accompanying post<\/a> on CardioExchange, Moss sheds additional light on the role of LBBB, QRS duration, and women in RAFT.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>RAFT (Resynchronization-Defibrillation for Ambulatory Heart Failure Trial) randomized 1798 patients with NYHA class II or III heart failure, LVEF &lt; 30%, and a wide QRS complex to either an ICD alone or an ICD-CRT. After a mean followup of 40 months, the rate of death or heart failure hospitalization was 40.3% in the ICD group [&hellip;]<\/p>\n","protected":false},"author":196,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[13,14],"tags":[467,542,305,543,544],"class_list":["post-4573","post","type-post","status-publish","format-standard","hentry","category-electrophysiology","category-heart-failure","tag-chf","tag-crt","tag-hf","tag-icd","tag-icd-crt"],"_links":{"self":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/posts\/4573","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/users\/196"}],"replies":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/comments?post=4573"}],"version-history":[{"count":0,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/posts\/4573\/revisions"}],"wp:attachment":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/media?parent=4573"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/categories?post=4573"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/tags?post=4573"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}