Effect of exercise training in patients with an implantable cardioverter defibrillator

Abstract

ICD patients can safely participate in an exercise training programme with favorable results. A randomised control study with evaluation of the physical and the psychosocial effects is warranted.

Safety Aspects of Implantable Cardioverter Defibrillators in Patients Participating in Exercise Therapy: A Systematic Review and Meta-Analysis

“…Few studies have evaluated ICD safety compared to non-ICD exercise controls and those published suggest that adverse events during exercise are not uncommon, reflecting the higher risk nature of ICD patients [19,20,35,37]. Our study suggests that compared to non-ICD controls, ET can be associated with a 2.6-fold increase in adverse events.…”

“…15 (3573 participants) [9,[18][19][20][28][29][30][31][32][33][34][35][36][37][38] studies collected data relevant to our outcomes of interest, specifically safety and/or adverse events during and/or after ET. Of these studies, 10 were examined by meta-analyses (3171 participants) [9,19,20,28,30,32,33,36,37,39] as they included a comparator control group: 7 studies (2498 participants) [9,28,30,32,33,36,37] used non-ET ICD controls compared to ET-ICD patients and 3 studies (673 participants) [19,20,38] used ET non-ICD patients compared to ET-ICD patients. Of the 10 studies, 7 had data relevant only to our primary outcome.…”

“…Findings from small, single center studies report that rates of ICD shocks during exercise therapy (ET) range from 2.3-12.5% [17] and that adverse cardiac event during ET are higher in ICD patients compared to non-ICD controls [18][19][20]. Despite the lack of more rigorous data, current exercise and cardiac rehabilitation guidelines make no recommendation for modified activity in ICD patients [21].…”

Are Cardiac Events During Exercise Therapy for Heart Failure Predictable From the Baseline Variables?

“…15 In the present patients, all of whom had a poorly functioning LV, 3 of 7 patients with an ICD experienced shocks for ventricular tachycardia or refractory ventricular tachycardia. Therefore, chronic heart failure patients with implanted pacemakers/ICDs seem to be more likely to develop CE while participating in an ET program.…”

Cardiac Rehabilitation for Patients with an Implantable Cardioverter Defibrillator

“…There is evidence that exercise programs can improve functional status and counter deconditioning in cardiac patients with heart failure ( Smart and Marwick 2004 ). Most previous studies which have examined the safety of exercising ICD patients have been small, with less than 100 patients in their studies ( Belardinelli et al, 2006;Chinnaiyan et al, 2007;Dougherty et al, 2008;Fan et al, 2009;Fitchet et al, 2003;Vanhees et al, 2004 ) . A notable exception was the HF-ACTION cohort, in which 1285 patients had an ICD implanted before or during the trial and had at least one exercise test performed after ICD implantation ( Keteylan et al, 2009 ).…”