RAFT Trial Among Top 10 Research Advances

February 2011

The American Heart Association and the American Stroke Association have named the RAFT trial among the top 10 research advances in heart disease in 2010. Led by the University of Ottawa Heart Institute, RAFT showed cardiac resynchronization therapy (CRT) is effective in reducing the risk for death from heart failure.

The RAFT trial tested implantation of a basic implantable cardioverter defibrillator (ICD) alone versus implantation of an ICD plus a CRT device in patients with symptoms of mild to moderate heart failure.

An ICD is similar to a pacemaker but can deliver an electrical shock to restore normal heart rhythms when needed. A CRT device delivers electrical impulses to the heart through insulated wires called leads that are connected to the heart tissue. These impulses do not “restart” the heart’s electrical signalling like an ICD but stimulate and coordinate the heart to beat in sync. In the RAFT trial, addition of a CRT to the standard ICD reduced the risk of death by 24 per cent.

The significance of the findings were further borne out in January when the online publication theheart.org characterized RAFT as “the tipping point” in favour of CRT for heart failure treatment. The comment came following an online article the same month in the Canadian Medical Association journal, CMAJ.

That paper, a meta-analysis of studies assessing CRT for heart failure authored by the Heart Institute’s George Wells et al., stated that “the cumulative evidence is now conclusive that the addition of cardiac resynchronization to optimal medical therapy or defibrillator therapy significantly reduces mortality among patients with heart failure.”