2021POST-4Vasovagal syncopeIn 133 patients with recurrent vasovagal syncope and no serious comorbidity, midodrine reduced the proportion of patients with at least one syncope episode over 12 months compared with placebo.
2021BIOSync CLSPacing for reflex syncopeIn 127 patients aged 40 years or older with severe recurrent reflex syncope and tilt-induced asystole, a dual-chamber pacemaker with closed-loop stimulation reduced recurrence of syncope compared with the same pacemaker programmed off.
2020PRAETORIANICDIn 849 patients needing a defibrillator but no pacing, a subcutaneous ICD was non-inferior to a transvenous ICD for device complications and inappropriate shocks.
2016DANISHICDIn 1,116 patients with non-ischaemic heart failure (EF ≤ 35 %), a prophylactic defibrillator did not reduce all-cause mortality compared with usual care.
2016POST-2Vasovagal syncopeIn 210 patients with recurrent vasovagal syncope, fludrocortisone did not significantly reduce the first recurrence of syncope over one year compared with placebo, although a benefit emerged once the dose had been stabilised.
2015REVERTVagal manoeuvresIn 433 adults presenting to the emergency department with supraventricular tachycardia, a modified Valsalva manoeuvre with supine repositioning and passive leg raise more than doubled cardioversion to sinus rhythm at 1 minute compared with the standard semi-recumbent Valsalva manoeuvre.
2012Cappato ISTInappropriate sinus tachycardiaIn 21 patients with symptomatic inappropriate sinus tachycardia, ivabradine eliminated most symptoms and lowered heart rate at rest, on standing and during exertion compared with placebo.
2012ISSUE-3Pacing for reflex syncopeIn 77 patients aged 40 years or older with recurrent reflex syncope and asystole documented by an implantable loop recorder, an active dual-chamber pacemaker reduced recurrence of syncope at 2 years compared with the same pacemaker programmed to sensing only.
2010RAFTCRTIn 1,798 patients with NYHA II-III heart failure, EF ≤ 30% and wide QRS, adding cardiac resynchronisation to an ICD reduced death or heart-failure hospitalisation compared with an ICD alone.
2009MADIT-CRTCRTIn 1,820 patients with mild heart failure (NYHA I–II) and a wide QRS, adding resynchronisation to a defibrillator reduced death or heart-failure events compared with a defibrillator alone.
2006POSTVasovagal syncopeIn 208 patients with recurrent vasovagal syncope and a positive tilt test, metoprolol at the highest tolerated dose did not reduce the first recurrence of syncope over one year compared with placebo.
2005SCD-HeFTICDIn 2,521 patients with heart failure (NYHA II–III, EF ≤ 35 %), an implantable defibrillator reduced all-cause mortality compared with placebo or amiodarone.
2005CARE-HFCRTIn 813 patients with heart failure and a wide QRS, cardiac resynchronisation therapy reduced death or unplanned cardiovascular hospitalisation compared with medical therapy.
2004COMPANIONCRTIn 1,520 patients with NYHA III-IV heart failure and QRS ≥ 120 ms, cardiac resynchronisation therapy (with or without a defibrillator) reduced all-cause death or hospitalisation compared with optimal medical therapy alone.
2003Pappone WPWPre-excitationIn 72 asymptomatic patients with a Wolff-Parkinson-White pattern judged high-risk on electrophysiological testing, prophylactic radiofrequency ablation of the accessory pathway markedly reduced arrhythmic events over 5 years compared with no treatment.
2003VPS-IIPacing for reflex syncopeIn 100 patients with recurrent severe vasovagal syncope who all received a dual-chamber pacemaker, active dual-chamber pacing did not significantly reduce recurrence of syncope within 6 months compared with the pacemaker programmed to sensing only.
2002MADIT-IIICDIn 1,232 patients with prior MI and an ejection fraction ≤ 30 %, a prophylactic implantable defibrillator reduced all-cause mortality compared with conventional therapy.