Feasibility and safety of early cardiac rehabilitation using remote electrocardiogram monitoring in patients with cardiac surgery 

Abstract

Background: To evaluate the safety and feasibility of a remote electrocardiogram monitoring-based cardiac rehabilitation (CR) program during an early postoperative period in patients with cardiac surgery. Methods: Five days after cardiac surgery, patients were referred to a CR department and participated in a low-intensity inpatient CR program. During 2 weeks of the home-based CR period after discharge, patients participated in aerobic and resistance exercises. electrocardiogram data were transmitted to a cloud where researchers closely monitored them and provided feedback to the patients via telephone calls. Grip strength (GS), 6-min walk distance (6MWD) and self-reported questionnaires were measured at three different time points: 5 days postsurgery (T1), predischarge (T2), and 2 weeks after discharge (T3). Squat endurance tests and CPET were performed only at T2 and T3. Results: Sixteen patients completed the study, seven of whom underwent coronary artery bypass graft surgery (CABG). During the period between T2 and T3, peak VO2 improved from 12.39±0.57 to 17.93±1.25 mL/kg/min (p<0.01). The squat endurance test improved from 16.69±2.31 to 21.81±2.31 (p<0.01). In a comparison of values of time points between T1 and T3, the GS improved from 28.30±1.66 to 30.40±1.70 kg (p=0.02) and 6 MWD increased from 249.33±20.92 to 387.02±22.77 m (p<0.01). The EQ-5D and SF-36 improved from 0.59±0.03 to 0.82±0.03 (p<0.01) and from 83.99±3.40 to 122.82±6.06 (p<0.01), and KASI improved from 5.44±0.58 to 26.11±2.70 (p<0.01). Conclusion: Early remote ECG monitoring-based CR programs are safe for patients who underwent cardiac surgery. Additionally, the program improved aerobic capacity, functional status, and quality of life. Trial registration: This study was registered with the Clinical Research Information Service (CRIS) under the trial registration number KCT0006444 on August 13, 2021.