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Objectives: To determine whether specialist nurse intervention improves outcome in patients with chronic heart failure.

Design: Randomised controlled trial.

Setting: Acute medical admissions unit in a teaching hospital.

Participants: 165 patients admitted with heart failure due to left ventricular systolic dysfunction. The intervention started before discharge and continued thereafter with home visits for up to 1 year.

Main outcome measures: Time to first event analysis of death from all causes or readmission to hospital with worsening heart failure.

Results: 31 patients (37%) in the intervention group died or were readmitted with heart failure compared with 45 (53%) in the usual care group (hazard ratio=0.61, 95% confidence interval 0.33 to 0.96).Compared with usual care, patients in the intervention group had fewer readmissions for any reason (86 v 114, P=0.018), fewer admissions for heart failure (19 v 45, P<0.001 …