14th International Congress
THE "NEW FRONTIERS"
OF ARRHYTHMIAS 2000

Jan. 29 - Feb. 5, 2000
Marilleva, Trento, Italy

RT-145

How MUSTT responds to the objections to MADIT

Seah Nisam.
Guidant Corporation, Belgium

Introduction

The results of the Multicenter Automatic Defibrillator Implantation Trial (MADIT) were first announced publicly at NASPE in 1996¹, and published by MADIT’s principal investigator, Moss et al in the New England Journal of Medicine late that year². The results, which showed a staggering 54% reduction in mortality for patients randomized to implantable cardioverter defibrillators (ICDs) compared to mainly amiodarone treatment, provoked strong reactions – both pro and con. This year’s Marilleva meeting marks nearly 5 years since MADIT was first announced. Numerous studies – on ICDs as well as on pharmacological antiarrhythmic therapy – have been concluded in these five years, and shed new light on MADIT. Of all these important studies, none has clarified the issues surrounding MADIT as well as the recently reported Multicenter UnSustained Tachycardia Trial (MUSTT)³. For reasons we will elaborate below, MUSTT provides answers to essentially all the objections⁴ initially made concerning MADIT’s methodology and results.