MADIT


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MADIT

Cardiology A clinical trial–Multicenter Automatic Defibrillator Implantation Trial that evaluated the effects of implanted defibrillators–IDs in Pts with CAD at high risk of ventricular arrhythmia
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This represents a significant improvement over the two-year MADIT II data, which showed one life saved for every 17 patients.
Sudden cardiac death primary prevention trials Trial (year reported) Population Additional risk markers MADIT (1996) (20) 196 patients with MI longer Asymptomatic NSVT with than 3 weeks before entry inducible VT not and LVEF suppressed by IV [less than or equal to] procainamide 0.
As a result of these landmark findings from MADIT and other studies, the American College of Cardiology, the North American Society of Pacing and Electrophysiology, and the American Heart Association issued joint guidelines calling for expanded use of ICDs for the primary prevention of sudden cardiac death.
The results of the MADIT II clinical trial, published earlier this year in the New England Journal of Medicine, demonstrated that placement of an ICD in patients with a prior myocardial infarction and a left ventricular ejection fraction of 30% or less resulted in a 5.
In 1996, Moss et al (12) reported the results of the MADIT I trial and recommended ICDs in all patients with nonsustained VT and inducible nonsuppressible VT at electrophysiologic study.
Not only can device therapy provide a reduction in the risk of sudden death--and that is what the MADIT II trial was all about--but it can also alleviate symptoms.
Previous trials, including MADIT, MUSTT and AVID, have demonstrated that implantable defibrillators improve survival in other patient populations.
Q: Could you share recent findings from the four-year MADIT II trial, published in the New England Journal of Medicine and reported on at the American College of Cardiology's annual scientific meeting?
This 34% relative risk reduction was in line with the 31% reduction seen with ICD therapy in MADIT II.
Basically, we found that only one-third of Americans who met existing ICD indications--prior to MADIT II--were actually receiving an ICD.
Inappropriate shocks occurred in 12% of patients and comprised 31% of all shocks in the MADIT II trial.