Cardiac rehabilitation in patientswith implantable defibrillators
2003
We examined patients with implantable cardioverter
defibrillators (ICD) in order to demonstrate their safe
participation in a standard rehabilitation program. Prospective cohort study of a consecutive series of
patients after ICD implantation. Setting Inpatient
rehabilitation center. A total of 118 patients (73.7% male, mean age 60±11 years)
took part for 23 ± 4 days in a standard inpatient rehabilitation
program including physical activity, psychological care, heart
function seminars, and resuscitation exercises with family
members. The following noninvasive tests were performed:
symptomlimited exercise testing, two-dimensional
echocardiography, Holter monitoring, telemetric ICD
interrogation, optional fluoroscopy or X-ray examination of the
thorax, and (in some patients) defibrillation threshold
testing. Out of 118 patients 101 patients (85.6%) participated in
regular ergometer training during which the initial workload of
23 ± 11 Watts could be increased to 45 ± 18 Watts. An individual
conditioning program was assigned to 15% (n = 17) patients,
thereby enabling the inclusion of all patients in the
rehabilitation process. Under these conditions 12 patients (10%)
experienced ICD malfunctions requiring therapy. As a consequence
of all cardiac function tests, ICD reprogramming was necessary
in 26 patients (22.1%). Following ICD implantation, patients may participate in a
standard rehabilitation program without serious complications
and with a significant increase in physical capacity. However,
ICD malfunction occurs in approximately 10% of patients.
Additional tests performed by skilled medical staff and
appropriate technical equipment allows the ICD program to be
optimized.
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