Advertisement
Canadian Journal of Cardiology

LONG TERM OUTCOMES OF THE RESYNCHRONIZATION-DEFIBRILLATION IN AMBULATORY HEART FAILURE TRIAL (RAFT) IN ATLANTIC CANADA

      This paper is only available as a PDF. To read, Please Download here.

      BACKGROUND

      The RAFT trial randomized patients with NYHA II or III heart failure on optimal medical therapy with EF ≤ 30% and widened QRS duration to implantation with cardiac resynchronization defibrillator (CRT-D) or defibrillator alone (ICD) and demonstrated a reduction in HF hospitalization and overall mortality with CRT-D over mean follow-up of 3.3 years. The longer-term effects of CRT are less certain.

      METHODS AND RESULTS

      A chart review of patients who participated in the RAFT trial in Atlantic Canada was performed. Patients from NB, PEI and NS were followed up based on the following composite primary outcome: Any death, heart failure hospitalization, heart transplant and ventricular assist device (VAD) implant in selected patients with complete data available. Secondary outcomes included individual components of the primary outcome, along with cardiovascular death (Death from HF, CAD or arrhythmia). Among 131 patients enrolled (80.7% male, mean age = 65.3y) 66 were randomized to CRT-D and 63 patients to ICD. Follow-up was available for 104 patients (51 in CRT-D and 53 in ICD subgroup). The mean period to the primary endpoint was 11.3 (11.2-14.7). The primary outcome at the end of follow-up occurred in 35 (66.8%) patients in the CRT-D subgroup and 41(77.3%) in the ICD subgroup (HR 0.57, 95% CI= 0.35 - 0.91, p = 0.019). Cardiovascular death was the main driver of the primary outcome (39.2% vs 56.5%, HR= 0.54, 95 CI- 0.030 - 0.94, p=0.031). There was no significant difference in HF hospitalization between both groups.

      CONCLUSION

      The effect of CRT on mortality and HF hospitalization observed during the randomized RAFT trial persisted during long-term follow-up. A national, multicentre follow-up, long-term study of the RAFT trial is currently underway.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Canadian Journal of Cardiology
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect