MADIT Trial

Multicenter Automatic Defibrillator Implantation Trial

ICD VS. Anitiarrythmic Drug Treatment in Post-MI Patients

Protocol:

Hypothesis:

To study whether, in patients with a previous MI and LV dysfunction, prophylactic therapy with an ICD can improve survival versus treatment with conventional medical therapy (e.g., amiodarone, beta-blockers/sotalol and class I antiarrhythmics).

Primary endpoint:

• Total mortality

Secondary endpoints:

• Arrhythmic mortality
• Costs and cost effectiveness

Status:

Start: December, 1990
Completion: March, 1996
Sample size: 196 patients

Results:

In post-MI patients at a high risk for VT, prophylactic therapy with an ICD reduced overall mortality by 54% and arrhythmic mortality by 75% compared with conventional medical therapy after a mean follow-up of 27 months.

References

1. Multicenter Automatic Defibrillator Implantation Trial (MADIT): design and clinical protocol. PACE, 1991;14:920-927.
2. Moss AJ, et al. Improved survival with an implanted defibrillator in patients with coronary disease at high risk for ventricular arrhythmia. Multicenter Automatic Defibrillator Implantation Trial Investigators. N Engl J Med. 1996;335:1933-1940.
3. Mushlin A, Jackson Hall WJ, Zwanziger J, et al. for the MADIT Investigators. The Cost-effectiveness of Automatic Implantable Cardiac Defibrillators: Results From MADIT. Circulation. 1998;97:2129-2135.

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