In late July 2021, a large retrospective study in heart failure (HF) patients with implantable cardioverter defibrillators (ICDs) was published in Circulation Cardiovascular Quality and Outcomes. The results suggest that even small increases in daily physical activity (PA) were associated with a boost in 1-year survival in these patients.
Cardiac rehabilitation (CR) programs have been shown to improve short- and long-term outcomes in patients with heart failure (HF) but continue to be underutilized, especially by women, the elderly, and minorities. Therefore, alternative approaches to reduce the CVD risk should be also considered. This study used PA data from ICD activity sensors to investigate clinical outcomes.
The study involved 41,731 Medicare beneficiaries (mean age, 73.5 years) who received an ICD from 2014 to 2016. ICD heart rate and activity sensor measurements were used to establish a personalized physical activity (PA) threshold for each patient in the first 3 weeks after ICD implantation. Thereafter, the ICD logged PA when the personalized PA threshold was exceeded. The mean baseline PA level was 128.9 minutes/day. At 3 years' follow-up, one-quarter of the patients had died and half had been hospitalized for HF.
In adjusted analysis, every 10 minutes of increased daily PA was associated with a 1.1% reduced risk for death (hazard ratio [HR], 0.989; 95% CI, 0.979 - 0.996) and a 1% reduced risk for HF hospitalization (HR, 0.99; 95% CI, 0.986 - 0.995) at 1-year follow-up (P < .001). It is noteworthy that only 3.2% of the total population participated in cardiac rehabilitation.
Reference: https://www.ahajournals.org/doi/10.1161/CIRCOUTCOMES.120.007580
