The Effects of Cardiac Resynchronization Therapy on Cardiovascular and Non-cardiovascular Hospitalization: A Long-term Follow-up MADIT-CRT Sub-study

Abstract

Introduction Little is known about the effects of cardiac resynchronization therapy (CRT-D) on hospitalizations during long-term follow up. We assessed the impact of CRT-D on CV and non-CV hospitalizations in patients randomized to implantable cardioverter-defibrillator (ICD) or CRT-D in the MADIT-CRT trial. Methods and Results MADIT-CRT randomized 1820 patients with mild heart failure (HF), low ejection fraction and a wide QRS to ICD or CRT-D. Hospitalization rates and lengths of hospital stay were compared. At an average of 5.6 years follow-up, there was a lower rate of all-cause hospitalizations in the CRT-D arm compared with the ICD group (72.6 events per 100 pt-years versus 82.6 events per 100 pt-years, p=0.020). This was driven by a reduction in CV-hospitalizations with CRT-D vs. ICD (28.8 events per 100 pt-years vs. 42.6 events per 100 pt-years, p Conclusions Among patients with NYHA class I/II heart failure, CRT-D therapy significantly reduces all-cause hospitalizations, HF, and CV hospitalizations with reductions in hospital length of stay. Any hospitalization was associated with an increased risk of death.