Multicenter InSync Randomized Clinical Evaluation (MIRACLE)

Purpose:
To evaluate the efficacy and safety of combined cardiac resynchronization therapy (CRT) for patients with heart failure.
Primary endpoints:
- Changes in NYHA Functional Class
- Quality of Life: Minnesota Living with Heart Failure Questionnaire
- 6-minute walk distance
Main secondary endpoints:
- Peak VO 2 and exercise time during cardiopulmonary exercise
- Left ventricular ejection fraction (LVEF), left ventricular end diastolic dimension (LVEDD), mitral regurgitation
- QRS duration
Status:
Enrollment period: November 1998 to
December 2000
- Follow-up: 6 months
- Sample size: 453 implanted patients (92.4% implant success rate)
Results:
In NYHA Classes III and IV systolic heart failure patients with intraventricular conduction delays, CRT significantly improved:
- Quality of life, functional class, and exercise capacity
- Cardiac function and structure
68% of CRT patients improved by one or more functional classes compared with 38% of control patients (p< 0.001)
Reference:
- Abraham WT, Fischer WG, Smith AL, et al, for the MIRACLE Study Group. Cardiac resynchronization in chronic heart failure. N Engl J Med. 2002;346:1845-1853.
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