title: High-intensity cardiac rehabilitation training of a firefighter after placement of an implantable cardioverter-defibrillator.
abstract: Firefighters who have received an implantable cardioverter-defibrillator (ICD) are asked to retire or are permanently placed on restricted duty because of concerns about their being incapacitated by an ICD shock during a fire emergency. We present the case of a 40-year-old firefighter who, after surviving sudden cardiac arrest and undergoing ICD implantation, sought to demonstrate his fitness for active duty by completing a high-intensity, occupation-specific cardiac rehabilitation training program. The report details the exercise training, ICD monitoring, and stress testing that he underwent. During the post-training treadmill stress test in firefighter turnout gear, the patient reached a functional capacity of 17 metabolic equivalents (METs), exceeding the 12-MET level required for his occupation. He had no ICD shock therapy or recurrent sustained arrhythmias during stress testing or at any time during his cardiac rehabilitation stay. By presenting this case, we hope to stimulate further discussion about firefighters who have an ICD, can meet the functional capacity requirements of their occupation, and want to return to work.
authors: Cardiac Rehabilitation Department (Adams, Kennedy, Berbarie) and the Electrophysiology/Pacemaker Department (DeJong), Baylor Heart and Vascular Hospital; the Division of Cardiology, Department of Internal Medicine, Baylor University Medical Center at Dallas and Baylor Heart and Vascular Hospital (Franklin, Berbarie); and Medtronic Inc., Dallas, Texas (Arnett). Dr. Berbarie is now with the Division of Cardiology, Department of Internal Medicine, University of Texas Medical Branch, Galveston, Texas.
authors: Jenny
authors: J
authors: Adams
authors: Cardiac Rehabilitation Department (Adams, Kennedy, Berbarie) and the Electrophysiology/Pacemaker Department (DeJong), Baylor Heart and Vascular Hospital; the Division of Cardiology, Department of Internal Medicine, Baylor University Medical Center at Dallas and Baylor Heart and Vascular Hospital (Franklin, Berbarie); and Medtronic Inc., Dallas, Texas (Arnett). Dr. Berbarie is now with the Division of Cardiology, Department of Internal Medicine, University of Texas Medical Branch, Galveston, Texas.
authors: Sandra
authors: S
authors: DeJong
authors: Cardiac Rehabilitation Department (Adams, Kennedy, Berbarie) and the Electrophysiology/Pacemaker Department (DeJong), Baylor Heart and Vascular Hospital; the Division of Cardiology, Department of Internal Medicine, Baylor University Medical Center at Dallas and Baylor Heart and Vascular Hospital (Franklin, Berbarie); and Medtronic Inc., Dallas, Texas (Arnett). Dr. Berbarie is now with the Division of Cardiology, Department of Internal Medicine, University of Texas Medical Branch, Galveston, Texas.
authors: Justin K
authors: JK
authors: Arnett
authors: Cardiac Rehabilitation Department (Adams, Kennedy, Berbarie) and the Electrophysiology/Pacemaker Department (DeJong), Baylor Heart and Vascular Hospital; the Division of Cardiology, Department of Internal Medicine, Baylor University Medical Center at Dallas and Baylor Heart and Vascular Hospital (Franklin, Berbarie); and Medtronic Inc., Dallas, Texas (Arnett). Dr. Berbarie is now with the Division of Cardiology, Department of Internal Medicine, University of Texas Medical Branch, Galveston, Texas.
authors: Kathleen
authors: K
authors: Kennedy
authors: Cardiac Rehabilitation Department (Adams, Kennedy, Berbarie) and the Electrophysiology/Pacemaker Department (DeJong), Baylor Heart and Vascular Hospital; the Division of Cardiology, Department of Internal Medicine, Baylor University Medical Center at Dallas and Baylor Heart and Vascular Hospital (Franklin, Berbarie); and Medtronic Inc., Dallas, Texas (Arnett). Dr. Berbarie is now with the Division of Cardiology, Department of Internal Medicine, University of Texas Medical Branch, Galveston, Texas.
authors: Jay O
authors: JO
authors: Franklin
authors: Cardiac Rehabilitation Department (Adams, Kennedy, Berbarie) and the Electrophysiology/Pacemaker Department (DeJong), Baylor Heart and Vascular Hospital; the Division of Cardiology, Department of Internal Medicine, Baylor University Medical Center at Dallas and Baylor Heart and Vascular Hospital (Franklin, Berbarie); and Medtronic Inc., Dallas, Texas (Arnett). Dr. Berbarie is now with the Division of Cardiology, Department of Internal Medicine, University of Texas Medical Branch, Galveston, Texas.
authors: Rafic F
authors: RF
authors: Berbarie