MADIT-CRT Responder Score: Explanation and Clinical Context The MADIT-CRT Responder Score was developed from the Multicenter Automatic Defibrillator Implantation Trial with Cardiac Resynchronization Therapy (MADIT-CRT) to identify heart failure patients most likely to experience reverse left ventricular remodeling and clinical benefit from CRT.
This score integrates key predictors including female sex, non-ischemic etiology, presence of LBBB morphology, longer QRS duration (≥150 ms), higher baseline LV volumes, and less advanced NYHA functional class. Patients with these features have a substantially higher probability of favorable LV remodeling and improved survival.
In the original analysis, female sex and LBBB morphology were the strongest independent predictors of CRT response. Patients with a score of ≥7 had approximately 80% probability of significant LV reverse remodeling, while those with a score ≤3 had less than 40% probability.
This tool aids clinicians in patient selection for CRT, complementing guideline-based indications. It is not a substitute for clinical judgment but provides a quantitative, evidence-based estimate derived from the MADIT-CRT population.
Reference:
Moss AJ, Hall WJ, Cannom DS, et al. Cardiac-Resynchronization Therapy for the Prevention of Heart-Failure Events. New England Journal of Medicine. 2009;361(14):1329–1338.
Goldenberg I, et al. Predictors of Response to Cardiac Resynchronization Therapy in the Multicenter Automatic Defibrillator Implantation Trial–Cardiac Resynchronization Therapy (MADIT-CRT). Circulation. 2012;126:822–829. doi:10.1161/CIRCULATIONAHA.112.096826