The primary composite end point-all-cause death or hospitalization-was reduced only in patients randomized to exercise training without a device ( hazard ratio [ HR ] 0.79 , 95 % confidence interval [ CI ] 0.67-0 .93 [ P = .004 ] ; RV lead : HR 1.04 , 95 % CI 0.84-1 .28 [ P = .74 ] ; BiV pacing : HR 1.05 , 95 % CI 0.82-1 .34 [ P = .72 ] ; interaction P = .058 ) .