{"id":"160e6bcd3ef5","type":"article","url":"https://hartvaat.nl/2024/01/18/raft-langetermijn-crt-d-bij-hartfalen-nejm-14-jaarsresultaten/","title":"RAFT langetermijn: CRT-D bij hartfalen — NEJM 14-jaarsresultaten","title_en":"Long-Term Outcomes of Resynchronization-Defibrillation for Heart Failure.","category":"hartfalen","category_label":"Hartfalen","professions":["cardioloog"],"tags":[],"journal":"The New England journal of medicine","doi":"10.1056/NEJMoa2304542","source_url":"https://doi.org/10.1056/NEJMoa2304542","authors":["John L Sapp","Soori Sivakumaran","Calum J Redpath","Habib Khan","Ratika Parkash","Derek V Exner","Jeff S Healey","Bernard Thibault","Laurence D Sterns","Nhat Hung N Lam","Jaimie Manlucu","Ahmed Mokhtar","Glen Sumner","Stuart McKinlay","Shane Kimber","Blandine Mondesert","Mario Talajic","Jean Rouleau","C Elizabeth McCarron","George Wells","Anthony S L Tang"],"significance":8,"published":"2024-01-18","source_date":"2024-01-18","image":"","kennis":["https://hartvaat.nl/kennis/hartfalen/icd-bij-hartfalen/","https://hartvaat.nl/kennis/farmacologie/betablokkers-cardiale-indicaties/"],"congress":"","summary_en":"The RAFT trial 14-year follow-up showed that CRT-D provides sustained survival benefit over ICD alone in patients with HFrEF and wide QRS. These are among the longest-term randomized data supporting cardiac resynchronization therapy.","created":"2026-07-03T10:30:45Z","updated":"2026-07-03T13:29:48Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"De RAFT-trial rapporteerde 14 jaar langetermijnuitkomsten: CRT-D verbeterde de overleving significant bij HFrEF met brede QRS vergeleken met ICD alleen. Het overlevingsvoordeel bleef duurzaam behouden over meer dan een decennium.","abstract_original":"BACKGROUND: The Resynchronization-Defibrillation for Ambulatory Heart Failure Trial (RAFT) showed a greater benefit with respect to mortality at 5 years among patients who received cardiac-resynchronization therapy (CRT) than among those who received implantable cardioverter-defibrillators (ICDs). However, the effect of CRT on long-term survival is not known. METHODS: We randomly assigned patients with New York Heart Association (NYHA) class II or III heart failure, a left ventricular ejection fraction of 30% or less, and an intrinsic QRS duration of 120 msec or more (or a paced QRS duration of 200 msec or more) to receive either an ICD alone or a CRT defibrillator (CRT-D). We assessed long-term outcomes among patients at the eight highest-enrolling participating sites. The primary outcome was death from any cause; the secondary outcome was a composite of death from any cause, heart transplantation, or implantation of a ventricular assist device. RESULTS: The trial enrolled 1798 patients, of whom 1050 were included in the long-term survival trial; the median duration of follow-up for the 1050 patients was 7.7 years (interquartile range, 3.9 to 12.8), and the median duration of follow-up for those who survived was 13.9 years (interquartile range, 12.8 to 15.7). Death occurred in 405 of 530 patients (76.4%) assigned to the ICD group and in 370 of 520 patients (71.2%) assigned to the CRT-D group. The time until death appeared to be longer for those assigned to receive a CRT-D than for those assigned to receive an ICD (acceleration factor, 0.80; 95% confidence interval, 0.69 to 0.92; P = 0.002). A secondary-outcome event occurred in 412 patients (77.7%) in the ICD group and in 392 (75.4%) in the CRT-D group. CONCLUSIONS: Among patients with a reduced ejection fraction, a widened QRS complex, and NYHA class II or III heart failure, the survival benefit associated with receipt of a CRT-D as compared with ICD appeared to be sustained during a median of nearly 14 years of follow-up. (RAFT ClinicalTrials.gov number, NCT00251251.)."}