RAFT

Resynchronization / Defibrillation for Ambulatory Heart Failure Trial

BACKGROUND: Although effective in patients with severe heart failure (HF), the benefit of
combining
bi i cardiac
di resynchronization
h
i ti therapy
th
(CRT) with
ith an implantable
i l t bl cardioverter-defibrillator
di
t d fib ill t
(ICD) in patients with mild to moderate HF is unclear. PURPOSE: To evaluate if adding CRT to ICD
and optical medical therapy will reduce mortality and HF hospitalization in patients with mild to
moderate (NYHA Class II or III) HF symptoms, LV dysfunction, and wide QRS duration.

%o
of patients

PRIMARY OUTCOME

45
40
35
30
25
20
15
10
5
0

P=0.0002

ICD

HR (95% CI) 0.75

ICD +
CRT

DESIGN Prospective,
DESIGN:
P
i
multicenter
li
(34 sites
i
in
i Canada,
C
d
Europe, Turkey, and Australia), randomized, double-blinded,
controlled clinical trial. 1,798 patients received either an ICD
or ICD with CRT plus optimal HF medical therapy. Primary
Outcome: Composite of all
all-cause
cause mortality and HF
hospitalization Secondary Outcomes: All-cause mortality, HF
hospitalization, death from CV cause
RESULTS: Primary Outcome 40.3% in ICD group vs
33.2% in ICD+CRT [HR (95%CI) 0.75 , P=0.0002] Secondary
Outcomes ICD vs ICD+CRT: all-cause mortality, 26.1% vs
20.8%; HF hospitalization, 26.1% vs 19.5%; death from CV
cause, 17.9% vs 14.5%
CONCLUSION: Adding CRT to ICD reduces all-cause
mortality and HF hospitalization in patients with NYHA Class
II or III HF, LV dysfunction, and wide QRS duration.

Death or HF hospitalization
A Tang, AHA Scientific Sessions, Chicago, Illinois, November 14, 2010

2010, American Heart Association. All rights reserved.