Increased physical activity after ICD implantation lowers the risk of death, hospitalization
Patients who become even a little more active after receiving an implantable cardioverter defibrillator (ICD) can lower their risk of hospitalization for heart failure (HF) or death, according to a new analysis published in Circulation: Cardiovascular Quality and Outcomes.
The study’s authors tracked data from nearly 42,000 Medicare beneficiaries who received an ICD from 2014 to 2016. The average patient age was 75 years old, 72% were male and 87% were white.
Overall, just 3% of patients included in the analysis participated in a cardiac rehabilitation (CR) program after receiving the ICD. The American College of Cardiology and American Heart Association both recommend CR programs for HF patients and any patients with a history of myocardial infarction, percutaneous coronary intervention or bypass surgery.
“CR programs offer patients a safe environment to increase physical activity after ICD implantation,” lead author Brett D. Atwater, MD, director of electrophysiology and electrophysiology research at Inova Heart and Vascular Institute in Fairfax, Virginia, said in a prepared statement. “Evidence has also shown cardiac rehab lessens the risk of additional hospitalization and death, but CR programs are underutilized, especially among women, the elderly, people from diverse racial and ethnic groups and those living in rural areas. The causes of underutilization are a combination of providers failing to prescribe and patients being unwilling to participate because of the time requirements for participation, the travel to and from the rehab facility and out of pocket costs associated with that.”
Patients that participated in a CR program saw their physical activity levels increase by nearly 10 minutes. Patients who did not participate in such programs, on the other hand, saw their physical activity decrease by approximately one minute. Also, CR program participation was associated with a 24% lower risk of death one to three years after ICD implantation.
Every 10 minutes of increased daily physical activity, the authors added, was associated with a 1.1% reduction in all-cause mortality and a 1% reduction in the risk of hospitalization for HF for the study’s entire patient population.
Atwater et al. also aimed to focus on the potential of increased physical activity unrelated to a CR program. Increasing physical activity outside of a CR program, the group found, was still associated with comparable benefits.
“This finding helps confirm prior research showing that cardiac rehabilitation is underutilized, and the benefits of increased physical activity obtained in cardiac rehabilitation programs also may be achievable at home, potentially offering another opportunity to improve outcomes in patients with ICDs,” Atwater added.
Read the full study here.
Michael has more than 18 years of experience as a professional writer and editor. He has written at length about cardiology, radiology, artificial intelligence and other key healthcare topics.