title: Device diagnostics and long-term clinical outcome in patients receiving cardiac resynchronization therapy.
abstract: OBJECTIVE
  This retrospective analysis sought to develop and validate a model using the measured diagnostic variables in cardiac resynchronization therapy (CRT) devices to predict mortality.
  
  
  RESULTS
  Data used in this analysis came from two CRT studies: Cardiac Resynchronization Therapy Registry Evaluating Patient Response with RENEWAL Family Devices (CRT RENEWAL) (n = 436) and Heart Failure-Heart Rate Variability (HF-HRV) (n = 838). Patients from CRT RENEWAL were used to create a model for risk of death using logistic regression and to create a scoring system that could be used to predict mortality. Results of both the logistic regression and the clinical risk score were validated in a cohort of patients from the HF-HRV study. Diagnostics significantly improved over time post-CRT implant (all P < 0.001) and were correlated with a trend of decreased risk of death. The regression model classified CRT RENEWAL patients into low (2.8%), moderate (6.9%), and high (13.8%) risk of death based on tertiles of their model predicted risk. The clinical risk score classified CRT RENEWAL patients into low (2.8%), moderate (10.1%), and high (13.4%) risk of death based on tertiles of their score. When both the regression model and the clinical risk score were applied to the HF-HRV study, each was able to classify patients into appropriate levels of risk.
  
  
  CONCLUSIONS
  Device diagnostics may be used to create models that predict the risk of death.
authors.affiliation: Cardiac Arrhythmia Service, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Boston, MA 02114-2696, USA. jsingh@partners.org
authors.forename: Jagmeet P
authors.initials: JP
authors.lastname: Singh
authors.forename: Lawrence S
authors.initials: LS
authors.lastname: Rosenthal
authors.forename: Patrick M
authors.initials: PM
authors.lastname: Hranitzky
authors.forename: Kellie Chase
authors.initials: KC
authors.lastname: Berg
authors.forename: Christopher M
authors.initials: CM
authors.lastname: Mullin
authors.forename: Lisa
authors.initials: L
authors.lastname: Thackeray
authors.forename: Andrew
authors.initials: A
authors.lastname: Kaplan
mesh_terms: D000368:Aged; D002304:Cardiac Pacing, Artificial / Q000401:mortality*; D020000:Decision Support Systems, Clinical; D004562:Electrocardiography / Q000379:methods* / Q000706:statistics & numerical data*; D005260:Female; D006333:Heart Failure / Q000175:diagnosis* / Q000401:mortality*; D006801:Humans; D015994:Incidence; D008297:Male; D011379:Prognosis; D016016:Proportional Hazards Models; D015203:Reproducibility of Results; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors; D012680:Sensitivity and Specificity; D016019:Survival Analysis; D015996:Survival Rate; D016896:Treatment Outcome; D014481:United States