New Trial Investigates Heart Failure Prevention

Heart failure (HF) is a major unresolved public health problem in the United States. Cardiologists diagnose about 500,000 new cases each year, and a reservoir of about five million patients with HF exists at any given time. It is the leading cause of hospitalization in the U.S, and is the most rapidly growing cardiovascular disorder.

While clinical research has identified, and helped to dramatically enhance, treatment options for HF patients, how to prevent HF, or significantly prolong its onset, is the focus of Guidant Corporation’s newest trial – MADIT-CRT (Multicenter Automatic Defibrillator Implantation Trial with Cardiac Resynchronization Therapy). Like MADIT and MADIT II, the MADIT-CRT trial is exclusively sponsored by Guidant under the leadership of principal investigator Dr. Arthur J. Moss, professor of medicine at the University of Rochester.

The trial, taking place at 15 medical centers in Canada and Europe, as well as 78 medical centers in the U.S., including Deborah Heart and Lung Center, is comparing the use of an implantable defibrillator that stimulates the right and left sides of the heart simultaneously to improve the efficiency of contraction (Biventricular ICD) to the conventional dual chamber defibrillator. Doctors hope to enroll 1,800 patients nationwide, and Raffaele Corbisiero, MD, Director, Section of Electrophysiology at Deborah expects at least 20 to 30 of those patients to come from Deborah.

Biventricular ICD therapy has been shown, in prior clinical trials, to improve survival in patients with more advanced forms of HF, compared to the best conventional therapy. By examining the use of cardiac resynchronization therapy defibrillators (CRT-D) in heart attack survivors with impaired cardiac function, MADIT-CRT researchers aim to determine if the Biventricular ICD can improve survival and quality of life in patients with milder forms of HF, and/or slow or halt the progression of the disease in high risk populations.

“While major advancements have been made in the treatment of heart failure, we are still uncertain as to whether prophylactic CRT in combination with an implantable cardioverter defibrillator can inhibit or slow the development of symptomatic HF and reduce all-cause mortality,” said Dr. Corbisiero, Deborah’s MADIT-CRT principle investigator. “The Trial’s aim is to determine if earlier intervention with CRT-D therapy can slow a patient’s progression from early stage heart failure to late stage heart failure.”