Heart failure & cardiomyopathies

Effect of the cardiac myosin activator omecamtiv mecarbil on ventricular arrhythmias, cardiac arrest, and sudden death in heart failure with reduced ejection fraction: the GALACTIC-HF trial

Eur J Heart FailPublished Secondary analysis of the GALACTIC-HF randomised trial

Primary resultResult — go to the resultHazard ratio 0.86 95% CI 0.75–1.00

Authors' conclusion

In this post hoc analysis of the GALACTIC-HF trial, we observed a potential reduction in life-threatening arrhythmia, cardiac arrest, and SD with OM treatment, especially in patients with severely reduced LVEF.

Study context

Population
Symptomatic chronic HF with LVEF ≤35%
Participants
8,232 participants
Comparison
Omecamtiv mecarbil vs placebo
Primary endpoint
Composite of:
  • First serious VA
  • Cardiac arrest
  • SD
Follow-up
Median 21.8 months
Methodological detailspost hoc analysis, placebo-controlled, ventricular arrhythmias (VA) and cardiac arrest investigator-reported adverse events; SD centrally adjudicated
  • Post hoc analysis
  • Placebo-controlled
  • VA and cardiac arrest investigator-reported adverse events; SD centrally adjudicated

Primary result

As reported in the abstract

Hazard ratio

0.86

95% CI 0.75–1.00

P = 0.054

Events by treatment group

Placebo

377

events

Omecamtiv mecarbil (OM)

329

events

OMvs Placebo
HR 0.86 (95% CI 0.75–1.00); P = 0.054

Further findings

OutcomeHR (95% CI)P value
Composite arrhythmic outcome, LVEF ≤ median 28% (subgroup)0.77 (0.63–0.94)P = 0.009

Composite arrhythmic outcome, severe HF (subgroup)

Association appeared consistent in severe HF

Original publication

Effect of the cardiac myosin activator omecamtiv mecarbil on ventricular arrhythmias, cardiac arrest, and sudden death in heart failure with reduced ejection fraction: the GALACTIC-HF trial. Eur J Heart Fail. Published 12 February 2026. doi:10.1093/ejhf/xuag023

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