Safety of Exercise-Based Cardiac Rehabilitation and Exercise Testing for Cardiac Patients in Japan

Saito, M.; Ueshima, Kenji; Saito, Muneyasu; Iwasaka, Toshiji; Daida, Hiroyuki; Kohzuki, Masahiro; Makita, Shigeru; Adachi, Hitoshi; Yokoi, Hiroyoshi; Omiya, Kazuto; Mikouchi, Hiroshi; Yokoyama, Hiroyuki; Goto, Yoichi

doi:10.1253/circj.cj-13-1590

Cited by 32 publications

(24 citation statements)

References 22 publications

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“…Indeed, such investigations have reported an outpatient cardiovascular [ ( F i g . _ 2 ) T D $ F I G ] event rate, including cardiac arrest and myocardial infarction, of only one per 26,715-81,101 patient-hours during exercise [14][15][16][17]. In contrast, existing evidence suggests that in-hospital rehabilitation is less safe.…”

Section: Discussionmentioning

confidence: 99%

Safety and efficacy of in-hospital cardiac rehabilitation following antiarrhythmic therapy for patients with electrical storm

Kato

Koike

Kuroki

et al. 2019

Journal of Cardiology

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Background: Exercise-based in-hospital rehabilitation for patients with electrical storm (ventricular tachycardia/ventricular fibrillation, VT/VF) following antiarrhythmic therapy may prevent the deleterious outcomes of prolonged immobility, but the safety and efficacy of this strategy are still uncertain. We retrospectively investigated the rate of electrical storm recurrence in patients receiving rehabilitation. Methods: Sixty-seven patients receiving therapy for electrical storm were included in this study. After treatment, patients were divided into rehabilitation (n = 39) and non-rehabilitation (n = 28) groups. Results: Incidences of electrical storm recurrence and VT/VF requiring anti-tachycardia pacing or electrical defibrillation did not differ significantly between the rehabilitation and non-rehabilitation groups (13% vs. 21% and 28% vs. 25%, respectively). However, early mobilization initiated 2 days after primary therapy was disadvantageous for electrical storm and VT/VF recurrence compared to later mobilization (21% vs. 6% and 34% vs. 19%, respectively). Although the activities of daily living (ADL) at admission were significantly lower in the rehabilitation group, the scores were restored to the level of the non-rehabilitation group at the time of discharge. Univariate analysis revealed that high B-type natriuretic peptide (hazard ratio [HR]: 3.2; 95% confidence interval [CI]: 1.1-11), decreased left ventricular ejection fraction, and elevated E/E 0 (HR: 3.4; 95% CI: 1.1-11) were associated with VT/VF recurrence. Conclusions: The incidence of electrical storm relapse is substantial following antiarrhythmic therapy, but it is not increased by in-hospital rehabilitation. Although caution is urged for early mobilization, sustaining mobility to resume activity is recommended because ADL levels tend to deteriorate as a result of prolonged bed rest.

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Section: Discussionmentioning

confidence: 99%

Safety and efficacy of in-hospital cardiac rehabilitation following antiarrhythmic therapy for patients with electrical storm

Kato

Koike

Kuroki

et al. 2019

Journal of Cardiology

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“…109 Of such studies, Japan appears to have some of the lowest rates of adverse events, with only 1 life-threatening adverse event occurring in 383,096 patienthours of ET. 110 The most serious CVD complications of structured ET for CVD patients are acute MI and sudden cardiac death, usually from ventricular fibrillation which can be triggered by exercise-induced myocardial ischemia, especially in patients with left ventricular dysfunction.…”

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confidence: 99%

Impact of cardiac rehabilitation and exercise training programs in coronary heart disease

Kachur

Chongthammakun

Lavie

et al. 2017

Progress in Cardiovascular Diseases

129

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“…believed that exercise acted on left ventricular remodeling in patients after aortic valve replacement by reducing left ventricular enddiastolic diameter and increasing left ventricular ejection fraction. Saito et al (2014) reported only one life-threatening adverse event occurred during the amount of 383,096 patient-hours of exercise training, resulted from a 136-center-participating study. Russo et al demonstrated the safety and effectiveness of the early exercise rehabilitation after aortic valve replacement or transcatheter aortic valve implantation under extracorporeal circulation in 158 patients aged 80 years or older (Russo et al, 2014).…”

Section: Discussionmentioning

confidence: 99%

Cardiac rehabilitation improved oxygen uptake measured by cardiopulmonary exercise test in patients after aortic valve surgery

Song

Zhan

Liang

et al. 2019

Reviews in Cardiovascular Medicine

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Evidence for cardiac rehabilitation after valve surgery remains scarce. We retrospectively enrolled consecutive patients undergoing aortic valve surgery. The intervention group consisted of physical exercise for 3 months after surgery, while the control group underwent usual care without physical exercise. It was observed that cardiac rehabilitation has a beneficial effect on the peak oxygen uptake compared to the control group (24.2 ml/kg/ min vs. 20.6 ml/kg/min) as measured by cardiopulmonary exercise testing 3 months after surgery. There was no significant difference observed in New York Heart Association class I or II between groups. Conversely, the intervention group underperformed the SF-36 Mental Component Scale at 3 months (50.3 vs. 53.8 points).

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Safety of Exercise-Based Cardiac Rehabilitation and Exercise Testing for Cardiac Patients in Japan

Cited by 32 publications

References 22 publications

Safety and efficacy of in-hospital cardiac rehabilitation following antiarrhythmic therapy for patients with electrical storm

Safety and efficacy of in-hospital cardiac rehabilitation following antiarrhythmic therapy for patients with electrical storm

Impact of cardiac rehabilitation and exercise training programs in coronary heart disease

Cardiac rehabilitation improved oxygen uptake measured by cardiopulmonary exercise test in patients after aortic valve surgery

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