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. 2023 Apr 18;12(8):2938. doi: 10.3390/jcm12082938

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© 2023 by the authors.

Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).

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Results of Landmark Trials of Cardiac Resynchronization Therapy. ICM = ischemic cardiomyopathy; NICM = non-ischemic cardiomyopathy; QRSd = QRS duration; LVEDD = left ventricular end diastolic volume; 6MWD = 6-min walk distance; OMT = optimal medical therapy; CRT-D = cardiac resynchronization with defibrillation capabilities; CRT-P = cardiac resynchronization with pacing therapy only; NYHA = New York Heart Association; QOL = quality of life; HR = hazard ratio; HF = heart failure; HFH = heart failure hospitalization; CV = cardiovascular; MIRACLE [41]: CRT-P resulted in significant improvement in LVEF (p < 0.001); fewer HFH in CRT-P group (15 vs. 8%, p < 0.05); all patients in sinus rhythm; LBBB in almost 70% of patients; COMPANION [42]: CRT-P and -D both reduced the risk of the primary outcome by approximately 20%; no significant difference in mortality with CRT-P; addition of defibrillator significantly reduced risk of all-cause mortality by 36%; all patients in sinus rhythm; LBBB in almost 70% of patients; CARE-HF [43]: Patients with QRSd 120–149 must have 2 out of 3 for inclusion: 1. aortic pre-ejection delay >140 ms; 2. Interventricular mechanical delay >40 ms; 3. Delayed activation of PL LV wall; Significant mortality benefit (HR 0.64, p < 0.002); improved LVESVi, MR, LVEF, symptoms, QOL (p < 0.01 for all comparisons); proportion of LBBB not reported; all patients in sinus rhythm; REVERSE [50]: Heart failure clinical composite = All-cause mortality, HFH, crossover due to worsening HF, NYHA class, patient global assessment; patients with previous HFH were excluded; All patients in sinus rhythm; LBBB in more than 65% of patients; no difference in mortality; significant delay in time to first HFH in CRT group; CRT resulted in significant reverse LV remodeling. MADIT-CRT [44]: 41% reduction in HF events drove primary endpoint; no difference in ICM vs. NICM; most benefit for patients with QRSd ≥150 ms; decreased LV volumes, improvements in LVEF; no difference in mortality; all patients in sinus rhythm; LBBB in more than 70% of patients; RAFT [45]: Significantly more adverse events in the CRT group; sinus rhythm or permanent atrial fibrillation/flutter with controlled ventricular rates or planned total AVN ablation; LBBB in more than 70%. of patients.