6/29/23, 12:42 AM RAFT Pathway Feedback Search Clinical Topics Home Studies RAFT RAFT Disease Disease Heart failure Ventricular arrhythmias Trial question What is the role of addition of cardiac-resynchronization therapy to an ICD in patients with LV systolic dysfunction and a wide QRS complex? Study design Multi-center Double blinded RCT Population Characteristics of study participants 17.0% female N = 1798 83.0% male 1798 patients (308 female, 1490 male) Inclusion criteria: patients with NYHA (NYHA) class II or III HF, an LVEF 30%, and an intrinsic QRS duration 120 msec or a paced QRS duration 200 msec Key exclusion criteria: life expectancy of < 1 year from noncardiac causes, intravenous inotropic agent in the last 4 days, acute coronary syndrome, tricuspid prosthetic valve, severe primary pulmonary disease Interventions N=894 ICD-CRT implantation (ICD plus cardiac-resynchronization therapy and optimal medical therapy) N=904 ICD implantation alone (ICD and optimal medical therapy) https://web.pathway.md/studies/recgx6Oiz6JLaXNvl 1/2 6/29/23, 12:42 AM RAFT Pathway Primary outcome Death or hospitalization for heart failure 40.3 % 40.3 33.2 30.2 % 20.1 % Significant decrease 10.1 % NNT = 14 0.0 % ICD-CRT implantation ICD implantation alone Significant decrease in death or hospitalization for HF (33.2% vs. 40.3%; HR 0.75, 95% CI 0.64 to 0.87) Secondary outcomes Significant decrease in death from any cause (20.8% vs. 26.1%; HR 0.75, 95% CI 0.62 to 0.91) Significant decrease in hospitalization for HF (19.5% vs. 26.1%; HR 0.68, 95% CI 0.56 to 0.83) Significant decrease in death due to cardiovascular causes (14.5% vs. 17.9%; HR 0.76, 95% CI 0.6 to 0.96) Safety outcomes Significant differences in adverse events at 30 after device implantation (118 vs. 61 events, p < 0.001). Conclusion In patients with NYHA (NYHA) class II or III HF, an LVEF 30%, and an intrinsic QRS duration 120 msec or a paced QRS duration 200 msec, ICD-CRT implantation was superior to ICD implantation alone with respect to death or hospitalization for HF. Reference Tang AS, Wells GA, Talajic M et al. Cardiac-resynchronization therapy for mild-to-moderate heart failure. N Engl J Med. 2010 Dec 16;363(25):2385-95. Open reference URL https://web.pathway.md/studies/recgx6Oiz6JLaXNvl 2/2