# RAFT langetermijn: CRT-D bij hartfalen — NEJM 14-jaarsresultaten

*geplaatst 2024-01-18 · Hartfalen · The New England journal of medicine · doi 10.1056/NEJMoa2304542 · https://hartvaat.nl/2024/01/18/raft-langetermijn-crt-d-bij-hartfalen-nejm-14-jaarsresultaten/*

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.

## English: Long-Term Outcomes of Resynchronization-Defibrillation for Heart Failure.

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.

## Abstract (original, from the publication)

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.).

Auteurs: 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

---
Bron: The New England journal of medicine, https://doi.org/10.1056/NEJMoa2304542. Bijgewerkt 2026-07-03T13:29:48Z. 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.