Benefits of cardiac rehabilitation in patients with implantable cardioverter-defibrillators: a patient survey.
OBJECTIVE
To determine whether participation in an outpatient cardiac rehabilitation (OCR) program increases exercise levels and decreases shocks in patients with implantable cardioverter-defibrillators (ICDs).


METHODS
Retrospective comparative survey.


METHODS
University tertiary-care ICD clinic.


METHODS
Patients with ICDs and coronary artery disease.


METHODS
Participation in OCR (nonrandomized).


METHODS
Exercise levels and OCR participation were determined through a telephone survey of patients with ICDs. The incidence of shock-treated arrhythmia was determined by review of charts and ICD data storage disks.


RESULTS
Of 82 patients (85% men; mean age, 61+/-8 y), 28 (34%) participated in OCR after receiving an ICD. There was no difference in age, sex, ejection fraction, or length of follow-up between OCR and non-OCR groups. Median intensity of regular exercise was 5.3 metabolic equivalents (METS) for OCR patients versus 3.5 METS for non-OCR patients (P<.02). In follow-up (mean, 48+/-3 mo), non-OCR patients were more likely to receive any shock, shocks during exercise, or shocks for ventricular arrhythmia during exercise than OCR patients (all P<.05). Non-OCR remained a predictor of shock after adjustment for exercise limitation (P<.05).


CONCLUSIONS
OCR patients exercised more and had fewer shocks. Physicians and health plans should encourage ICD patients to participate in OCR.
Davids
Jennifer S
JS
Section of Cardiovascular Medicine, Yale University Medical School, New Haven, CT 06520, USA.
McPherson
Craig A
CA
Earley
Christine
C
Batsford
William P
WP
Lampert
Rachel
R
D000293:Adolescent; D000328:Adult; D000368:Aged; D000553:Ambulatory Care; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D001145:Arrhythmias, Cardiac / Q000628:therapy; D003324:Coronary Artery Disease / Q000534:rehabilitation*; D017147:Defibrillators, Implantable; D004554:Electric Countershock / Q000706:statistics & numerical data*; D015444:Exercise; D005260:Female; D015438:Health Behavior; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D014481:United States
D000889:Anti-Arrhythmia Agents