title: Impact of cardiac resynchronization therapy on hospitalizations in the Resynchronization-Defibrillation for Ambulatory Heart Failure trial.
abstract: BACKGROUND
  This study reports the impact of cardiac resynchronization therapy (CRT) on hospitalizations in patients randomized to implantable cardioverter-defibrillator (ICD) or ICD-CRT in the Resynchronization-Defibrillation for Ambulatory Heart Failure Trial (RAFT).
  
  
  RESULTS
  Hospitalization rates and lengths of hospital stay were compared between the 2 groups. At the 18-month follow-up, the numbers of patients hospitalized for any cause were similar in the ICD (n=351, 38.8%) and ICD-CRT (n=331, 30.0%) groups. The number of patients hospitalized for heart failure was significantly lower in the ICD-CRT (n=101, 11.3%) compared with the ICD (n=141, 15.6%; P=0.003) group. The number of patients hospitalized for a device-related indication was similar in the ICD-CRT group (n=147, 16.4%) and ICD group (n=126, 13.9%; P=0.148). The total number of hospitalizations for any cause (n=1448 versus n=1553; P=0.042), any cardiovascular cause (n=667 versus n=790; P=0.017), and any heart failure cause (n=385 versus n=505; P<0.0001) was significantly lower in ICD-CRT group compared with the ICD group, whereas the number of hospitalizations for device-related causes was significantly higher in the ICD-CRT group compared with the ICD group (246 versus 159; P<0.001). Although the reduction in hospitalizations for heart failure in the CRT-ICD group was offset by an increased number of hospitalizations for device-related indications, the length of hospital stay for any cause was significantly shorter in the ICD-CRT group (8.83±13.30 days) compared with the ICD group (9.59±14.40 days; P=0.005).
  
  
  CONCLUSIONS
  ICD-CRT therapy significantly reduces hospitalizations and total days in hospital in patients with New York Heart Association class II/III heart failure compared with ICD therapy despite increased admissions for device-related indications.
  
  
  BACKGROUND
  http://www.clinicaltrials.gov. Unique identifier: NCT00251251.
authors.affiliation: From the Department of Cardiac Sciences, University of Calgary, Libin Cardiovascular Institute of Alberta, Calgary, AB, Canada (A.M.B.); St. Paul's Hospital, Vancouver, BC, Canada (C.R.K.); Quebec Heart and Lung Institute, Sainte Foy, QC, Canada (F.P.); Mount Sinai Hospital, Toronto, ON, Canada (G.N.); Montreal Heart Institute and Université de Montreal, Montreal, QC, Canada (M.T.); University of Ottawa Heart Institute, Ottawa, ON, Canada (M.F., E.Y., G.A.W., A.S.T.); University of Ottawa, Ottawa, ON, Canada (S.F.); and Island Medical Program, University of British Columbia, Victoria, BC, Canada (E.S., A.S.T.). amgillis@ucalgary.ca.
authors.forename: Anne M
authors.initials: AM
authors.lastname: Gillis
authors.affiliation: From the Department of Cardiac Sciences, University of Calgary, Libin Cardiovascular Institute of Alberta, Calgary, AB, Canada (A.M.B.); St. Paul's Hospital, Vancouver, BC, Canada (C.R.K.); Quebec Heart and Lung Institute, Sainte Foy, QC, Canada (F.P.); Mount Sinai Hospital, Toronto, ON, Canada (G.N.); Montreal Heart Institute and Université de Montreal, Montreal, QC, Canada (M.T.); University of Ottawa Heart Institute, Ottawa, ON, Canada (M.F., E.Y., G.A.W., A.S.T.); University of Ottawa, Ottawa, ON, Canada (S.F.); and Island Medical Program, University of British Columbia, Victoria, BC, Canada (E.S., A.S.T.).
authors.forename: Charles R
authors.initials: CR
authors.lastname: Kerr
authors.affiliation: From the Department of Cardiac Sciences, University of Calgary, Libin Cardiovascular Institute of Alberta, Calgary, AB, Canada (A.M.B.); St. Paul's Hospital, Vancouver, BC, Canada (C.R.K.); Quebec Heart and Lung Institute, Sainte Foy, QC, Canada (F.P.); Mount Sinai Hospital, Toronto, ON, Canada (G.N.); Montreal Heart Institute and Université de Montreal, Montreal, QC, Canada (M.T.); University of Ottawa Heart Institute, Ottawa, ON, Canada (M.F., E.Y., G.A.W., A.S.T.); University of Ottawa, Ottawa, ON, Canada (S.F.); and Island Medical Program, University of British Columbia, Victoria, BC, Canada (E.S., A.S.T.).
authors.forename: François
authors.initials: F
authors.lastname: Philippon
authors.affiliation: From the Department of Cardiac Sciences, University of Calgary, Libin Cardiovascular Institute of Alberta, Calgary, AB, Canada (A.M.B.); St. Paul's Hospital, Vancouver, BC, Canada (C.R.K.); Quebec Heart and Lung Institute, Sainte Foy, QC, Canada (F.P.); Mount Sinai Hospital, Toronto, ON, Canada (G.N.); Montreal Heart Institute and Université de Montreal, Montreal, QC, Canada (M.T.); University of Ottawa Heart Institute, Ottawa, ON, Canada (M.F., E.Y., G.A.W., A.S.T.); University of Ottawa, Ottawa, ON, Canada (S.F.); and Island Medical Program, University of British Columbia, Victoria, BC, Canada (E.S., A.S.T.).
authors.forename: Gary
authors.initials: G
authors.lastname: Newton
authors.affiliation: From the Department of Cardiac Sciences, University of Calgary, Libin Cardiovascular Institute of Alberta, Calgary, AB, Canada (A.M.B.); St. Paul's Hospital, Vancouver, BC, Canada (C.R.K.); Quebec Heart and Lung Institute, Sainte Foy, QC, Canada (F.P.); Mount Sinai Hospital, Toronto, ON, Canada (G.N.); Montreal Heart Institute and Université de Montreal, Montreal, QC, Canada (M.T.); University of Ottawa Heart Institute, Ottawa, ON, Canada (M.F., E.Y., G.A.W., A.S.T.); University of Ottawa, Ottawa, ON, Canada (S.F.); and Island Medical Program, University of British Columbia, Victoria, BC, Canada (E.S., A.S.T.).
authors.forename: Mario
authors.initials: M
authors.lastname: Talajic
authors.affiliation: From the Department of Cardiac Sciences, University of Calgary, Libin Cardiovascular Institute of Alberta, Calgary, AB, Canada (A.M.B.); St. Paul's Hospital, Vancouver, BC, Canada (C.R.K.); Quebec Heart and Lung Institute, Sainte Foy, QC, Canada (F.P.); Mount Sinai Hospital, Toronto, ON, Canada (G.N.); Montreal Heart Institute and Université de Montreal, Montreal, QC, Canada (M.T.); University of Ottawa Heart Institute, Ottawa, ON, Canada (M.F., E.Y., G.A.W., A.S.T.); University of Ottawa, Ottawa, ON, Canada (S.F.); and Island Medical Program, University of British Columbia, Victoria, BC, Canada (E.S., A.S.T.).
authors.forename: Michael
authors.initials: M
authors.lastname: Froeschl
authors.affiliation: From the Department of Cardiac Sciences, University of Calgary, Libin Cardiovascular Institute of Alberta, Calgary, AB, Canada (A.M.B.); St. Paul's Hospital, Vancouver, BC, Canada (C.R.K.); Quebec Heart and Lung Institute, Sainte Foy, QC, Canada (F.P.); Mount Sinai Hospital, Toronto, ON, Canada (G.N.); Montreal Heart Institute and Université de Montreal, Montreal, QC, Canada (M.T.); University of Ottawa Heart Institute, Ottawa, ON, Canada (M.F., E.Y., G.A.W., A.S.T.); University of Ottawa, Ottawa, ON, Canada (S.F.); and Island Medical Program, University of British Columbia, Victoria, BC, Canada (E.S., A.S.T.).
authors.forename: Sandra
authors.initials: S
authors.lastname: Froeschl
authors.affiliation: From the Department of Cardiac Sciences, University of Calgary, Libin Cardiovascular Institute of Alberta, Calgary, AB, Canada (A.M.B.); St. Paul's Hospital, Vancouver, BC, Canada (C.R.K.); Quebec Heart and Lung Institute, Sainte Foy, QC, Canada (F.P.); Mount Sinai Hospital, Toronto, ON, Canada (G.N.); Montreal Heart Institute and Université de Montreal, Montreal, QC, Canada (M.T.); University of Ottawa Heart Institute, Ottawa, ON, Canada (M.F., E.Y., G.A.W., A.S.T.); University of Ottawa, Ottawa, ON, Canada (S.F.); and Island Medical Program, University of British Columbia, Victoria, BC, Canada (E.S., A.S.T.).
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Swiggum
authors.affiliation: From the Department of Cardiac Sciences, University of Calgary, Libin Cardiovascular Institute of Alberta, Calgary, AB, Canada (A.M.B.); St. Paul's Hospital, Vancouver, BC, Canada (C.R.K.); Quebec Heart and Lung Institute, Sainte Foy, QC, Canada (F.P.); Mount Sinai Hospital, Toronto, ON, Canada (G.N.); Montreal Heart Institute and Université de Montreal, Montreal, QC, Canada (M.T.); University of Ottawa Heart Institute, Ottawa, ON, Canada (M.F., E.Y., G.A.W., A.S.T.); University of Ottawa, Ottawa, ON, Canada (S.F.); and Island Medical Program, University of British Columbia, Victoria, BC, Canada (E.S., A.S.T.).
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Yetisir
authors.affiliation: From the Department of Cardiac Sciences, University of Calgary, Libin Cardiovascular Institute of Alberta, Calgary, AB, Canada (A.M.B.); St. Paul's Hospital, Vancouver, BC, Canada (C.R.K.); Quebec Heart and Lung Institute, Sainte Foy, QC, Canada (F.P.); Mount Sinai Hospital, Toronto, ON, Canada (G.N.); Montreal Heart Institute and Université de Montreal, Montreal, QC, Canada (M.T.); University of Ottawa Heart Institute, Ottawa, ON, Canada (M.F., E.Y., G.A.W., A.S.T.); University of Ottawa, Ottawa, ON, Canada (S.F.); and Island Medical Program, University of British Columbia, Victoria, BC, Canada (E.S., A.S.T.).
authors.forename: George A
authors.initials: GA
authors.lastname: Wells
authors.affiliation: From the Department of Cardiac Sciences, University of Calgary, Libin Cardiovascular Institute of Alberta, Calgary, AB, Canada (A.M.B.); St. Paul's Hospital, Vancouver, BC, Canada (C.R.K.); Quebec Heart and Lung Institute, Sainte Foy, QC, Canada (F.P.); Mount Sinai Hospital, Toronto, ON, Canada (G.N.); Montreal Heart Institute and Université de Montreal, Montreal, QC, Canada (M.T.); University of Ottawa Heart Institute, Ottawa, ON, Canada (M.F., E.Y., G.A.W., A.S.T.); University of Ottawa, Ottawa, ON, Canada (S.F.); and Island Medical Program, University of British Columbia, Victoria, BC, Canada (E.S., A.S.T.).
authors.forename: Anthony S
authors.initials: AS
authors.lastname: Tang
mesh_terms: D000368:Aged; D058406:Cardiac Resynchronization Therapy / Q000379:methods*; D017147:Defibrillators, Implantable; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000401:mortality / Q000628:therapy*; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D053208:Kaplan-Meier Estimate; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D010359:Patient Readmission / Q000706:statistics & numerical data*; D016016:Proportional Hazards Models; D012307:Risk Factors; D055502:Secondary Prevention
keywords: cardiac resynchronization therapy; heart failure; hospitalization