scholarly journals Impact of the Covid-19 related lockdown on physical activity, heart rate and arrhythmia burden in a large prospective cohort of CHF patients

EP Europace ◽  
2021 ◽  
Vol 23 (Supplement_3) ◽  
Author(s):  
J Schmitt ◽  
J De Sousa ◽  
A Bulava ◽  
G Golovchiner ◽  
R Hatala ◽  
...  
Keyword(s):  
Physical Activity ◽  
Heart Failure ◽  
Heart Rate ◽  
Social Stress ◽  
Biventricular Pacing ◽  
Atrial Arrhythmia ◽  
Cardiac Resynchronization ◽  
Private Company ◽  
The Impact ◽  
Mean Heart Rate

Abstract Funding Acknowledgements Type of funding sources: Private company. Main funding source(s): BIOTRONIK SE & Co. KG OnBehalf BIO|STREAM.HF Background At the beginning of the Covid-19 pandemic in spring 2020, governments around the world issued curfews and other stay at home orders (‘lockdown’) to limit the spread of the SARS-CoV19 virus. This may have forced people to decrease their physical activity. Physical inactivity as well as social stress is known to be especially deleterious for heart failure (HF) patients. The BIO|STREAM.HF study enrolled such HF patients into a prospective registry with Home Monitoring. Purpose We aimed to evaluate the impact of the lockdown during the first Covid-19 pandemic wave on physical activity and arrhythmia burden of heart failure patients. Methods We analysed daily transmitted data of patients enrolled into a large international registry (BIO|STREAM.HF) being implanted with a cardiac resynchronization therapy (CRT) devices. Patients with NYHA ≥ II and LVEF ≤ 40% before CRT implantation were selected. Intra-individual weekly mean and median values were calculated for the following daily transmitted parameters: physical activity (measured as % of the day during which the patient moves), atrial arrhythmia burden, mean heart rate (at rest), PP variability, PVC burden, and rate of biventricular pacing. Values were calculated for 12 weeks before and 12 weeks after the country-specific effective date of most rigorous restrictions in spring 2020 to visualize the general trend of parameter changes. Moreover, values for intra-individual changes between three 28-days periods (before, during, and after the lockdown) were calculated. Results Of 444 patients, 76% were male. They had a mean age of 69 ± 10 years and LVEF of 28.2 ± 6.7%. HF was of ischemic etiology in 42% of cases and they were in NYHA class II (47.5%), III (50.0%) or IV (2.5%). On average, patients were active for 9% of the day (2 h 10 min). The physical activity decreased by approx. 10% with the onset of the lockdown (figure 1) and recovered within the following eight weeks. Comparison of the 28-days periods before, during and after the lockdown showed a statistically significant intra-individual decrease in physical activity (mean decrease 9 min per day) during the lockdown compared to pre- and post-lockdown values and a trend toward reduced mean heart rates. In parallel, a significant increase in device detected atrial arrhythmia burden (mean increase 17 min per day) was observed. All other parameters did not change significantly. Conclusion  Our results show that patients reduced their physical activity during the Covid-19 related lockdown in spring 2020. This was associated with an increase in atrial arrhythmia burden and a reduction of the mean heart rate. Prognostic implications of these results will further be analysed. Abstract Figure.

scholarly journals Impact of lockdown in patients with congestive heart failure during the Covid-19 pandemic

2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
F Chague ◽  
M Boulin ◽  
JC Eicher ◽  
F Bichat ◽  
M Saint-Jalmes ◽  
...  
Keyword(s):  
Physical Activity ◽  
Heart Failure ◽  
Congestive Heart Failure ◽  
Screen Time ◽  
Salt Water ◽  
Well Being ◽  
Phone Call ◽  
P Value ◽  
Private Company ◽  
The Impact

Abstract Funding Acknowledgements Type of funding sources: Private company. Main funding source(s): Dijon Football Côte d"Or OnBehalf CLEO-CD Background Congestive heart failure (CHF) can be destabilized by Covid-19 (C19) lockdown. Purpose To evaluate the impact of lockdown in CHF patients. Methods 150 out-patients from the HF Clinic of our hospital were invited to answer to a phone-call interview during the 7th week of first C19 lockdown . Results From 124 questionnaires, more than 1/5 felt worse and almost 1/4 declared a psychologic distress. CHF medications were modified in 10%. Decrease in physical activity was observed in 2/5. Almost 1/2 declared increased screen time;  smokers often increased consumption. Adherence to dietary counselling was reduced by 1/6, increase in weight and HF symptoms were common. Some patients benefitted from a teleconsultation. Conclusions Our patients exhibited well-being impairment and unhealthy behaviours. Medication adherence was not diminished and the reduction in care access was counterbalanced by a switch toward telehealth. Main results 124 patients 75 Male (M) 49 Female (F) p value between M and F Age, years 71.0 ± 14.0 68.9 ± 13.7 74.3 ± 14.0 0.03 Urban/Rural 82/42 49/26 33/16 0.84 HFrEF* 87 62 25 <0.001 Dilated cardiomyopathy 50 37 13 0.02 Ischemic 23 18 5 0.06 Other 51 20 31 <0.0001 Current NYHA class I/II/III/IV 39/48/28/9 29/29/14/3 10/19/14/6 0.66 History of NYHA III-IV class 94 62 32 0.03 Electronic device/Telemonitoring 77/28 54/18 23/10 <0.001/0.66 Increase in dyspnea or edema or fatigue 27 13 14 0.07 Decrease in well-being 27 12 15 0.07 Psychological distress (#) 23 15 (20.0) 8 0.64 Weight gain > 2 kg 34 22 (29.3) 12 0.68 Switch for teleconsultation (##) 16 11 (34.4) 5 1 Teleconsultation (total) 23 14 9 1 Decrease in physical activity 52 25 (33.3) 27 0.02 Increase in screen time 57 31 (41.3) 26 0.27 Increase in cigarette consumption (9 smokers) 4 3 1 1 Decrease in dietary adherence (###) 22 (17.7) 15 (20.0) 7 (14.3) 0.47 *HFrEF; # Kessler-6 score ≥ 5; ## from planned physical examination; ### salt, water, alcohol

scholarly journals Impact of COVID-19 lockdown in patients with implantable cardioverter and cardiac resynchronization therapy defibrillators: insights from daily remote monitoring transmissions

EP Europace ◽  
2021 ◽  
Vol 23 (Supplement_3) ◽  
Author(s):  
G Mascioli ◽  
E Lucca ◽  
P Napoli ◽  
D Giacopelli
Keyword(s):  
Physical Activity ◽  
Heart Rate ◽  
Cardiac Resynchronization Therapy ◽  
Remote Monitoring ◽  
Cardiac Resynchronization ◽  
Relative Reduction ◽  
Study Cohort ◽  
Resynchronization Therapy ◽  
The Mean ◽  
Mean Heart Rate

Abstract Funding Acknowledgements Type of funding sources: None. Background In Italy, a strict lockdown was imposed from 8 March 2020 to stop the spread of the Coronavirus Disease 2019 (COVID-19). Purpose To explore the effect of this lockdown on data transmitted by remote monitoring (RM) of implantable cardioverter and cardiac resynchronization therapy defibrillators (ICDs/CRT-Ds). Methods RM daily transmissions from ICDs and CRT-Ds were analyzed and compared in two consecutive 1-month frames pre- and post-lockdown: Period I (7 February–7 March 2020) and Period II (8 March–7 April 2020). Results The study cohort included 180 patients (81.1% male, 63.3% ICDs and 36.7% CRT-Ds) with a median age of 70 (interquartile range 62-78) years. The median value of physical activity provided by accelerometric sensors showed a significant reduction between Period I and II (13.1% [8.2-18.1%] versus 9.4% [6.3-13.8%], p < 0.001]. Eighty-nine percent of patients decreased their activity, for 43.3% the relative reduction was ≥25%. The mean heart rate decreased significantly (69.2 [63.8-75.6] bpm vs 67.9 [62.7- 75.3] bpm, p < 0.001), but with greater reduction (≈3 beats/minute) in patients aged < 70 years. Resting heart rate and thoracic impedance showed minor variations. No differences were observed in device pacing percentages and arrhythmias. Conclusions In cardiac patients, the lockdown imposed to contain COVID-19 outbreak significantly reduced the amount of physical activity and the mean heart rate. These side effects of in-home confinement quarantine should be taken in consideration for frail patients. Abstract Figure. Activity and mean heart rate trends

Monitoring of Physical Activity and Heart Rate Variability in Patients With Chronic Heart Failure Using Cardiac Resynchronization Devices

2005 ◽  
Vol 95 (9) ◽  
pp. 1104-1107 ◽  
Author(s):  
Frieder Braunschweig ◽  
Peter T. Mortensen ◽  
Daniel Gras ◽  
Wolfgang Reiser ◽  
Thomas Lawo ◽  
...  
Keyword(s):  
Physical Activity ◽  
Heart Failure ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Chronic Heart Failure ◽  
Cardiac Resynchronization

scholarly journals Associations between left bundle branch block with different PR intervals, QRS durations, heart rates and the risk of heart failure: a register-based cohort study using ECG data from the primary care setting

Open Heart ◽  
2021 ◽  
Vol 8 (1) ◽  
pp. e001425
Author(s):  
Marc Meller Søndergaard ◽  
Johannes Riis ◽  
Karoline Willum Bodker ◽  
Steen Møller Hansen ◽  
Jesper Nielsen ◽  
...  
Keyword(s):  
Heart Failure ◽  
Primary Care ◽  
Heart Rate ◽  
Left Bundle Branch Block ◽  
Bundle Branch Block ◽  
Increased Risk ◽  
Pr Interval ◽  
Qrs Duration ◽  
The Impact

AimLeft bundle branch block (LBBB) is associated with an increased risk of heart failure (HF). We assessed the impact of common ECG parameters on this association using large-scale data.Methods and resultsUsing ECGs recorded in a large primary care population from 2001 to 2011, we identified HF-naive patients with a first-time LBBB ECG. We obtained information on sex, age, emigration, medication, diseases and death from Danish registries. We investigated the association between the PR interval, QRS duration, and heart rate and the risk of HF over a 2-year follow-up period using Cox regression analysis.Of 2471 included patients with LBBB, 464 (18.8%) developed HF during follow-up. A significant interaction was found between QRS duration and heart rate (p<0.01), and the analyses were stratified on these parameters. Using a QRS duration <150 ms and a heart rate <70 beats per minute (bpm) as the reference, all groups were statistically significantly associated with the development of HF. Patients with a QRS duration ≥150 ms and heart rate ≥70 bpm had the highest risk of developing HF (HR 3.17 (95% CI 2.41 to 4.18, p<0.001). There was no association between the PR interval and HF after adjustment.ConclusionProlonged QRS duration and higher heart rate were associated with increased risk of HF among primary care patients with LBBB, while no association was observed with PR interval. Patients with LBBB with both a prolonged QRS duration (≥150 ms) and higher heart rate (≥70 bpm) have the highest risk of developing HF.

Effect of physical activity on cardiac autonomic function of dairy cows on commercial dairy farms

2017 ◽  
Vol 84 (4) ◽  
pp. 395-400
Author(s):  
Fruzsina Luca Kézér ◽  
János Tőzsér ◽  
Mikolt Bakony ◽  
Ottó Szenci ◽  
Viktor Jurkovich ◽  
...  
Keyword(s):  
Physical Activity ◽  
Heart Rate ◽  
Dairy Cows ◽  
Social Stress ◽  
Sympathetic Activity ◽  
Interval Data ◽  
Herd Size ◽  
Vagal Activity ◽  
Lactating Dairy Cows ◽  
Baseline Values

Interbeat interval data were collected from 219 Holstein cows in 2 smaller-scale farms and 3 larger-scale farms to investigate the effects of posture (standing vs. lying), rumination (rumination vs. no rumination) and feeding on baseline values of heart rate (HR) and heart rate variability (HRV) parameters reflecting vagal and sympathetic activity. A General Linear Model was used for detecting factors (parity, milking technology, herd size) having possible effects on HRV calculated for undisturbed lying posture. Basal values of cardiac parameters were also compared between larger and smaller-scale farms. Neither parity nor milking technology affected HRV parameters. Sympathetic activity increased in the order of lying, ruminating when lying, standing, ruminating when standing and feeding on both sizes of farms. Vagal activity decreased in that order in both lower- and larger-scale farms. Rumination caused an increase in HR and a decrease in vagal tone in both lower- and larger-scale farms and an increase in sympathetic activity during lying in both farm sizes. Basal vagal activity was lower in larger-scale farms compared to smaller-scale farms, while greater sympathetic activity was found in cows housed on larger-scale farms. Our findings demonstrate that reference values of HRV parameters in lactating dairy cows cannot be generally defined for Holstein cattle as they are affected by physical activity and herd size. Higher HR and sympathetic activity at rest in larger-scale farms compared to farms with lower cow population might be associated with higher levels of social stress and therefore should be considered as a potential welfare concern.

Abstract 17891: Impact of Physical Activity and Sedentary Time on Heart Failure Outcomes

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Rami Doukky ◽  
Marie-France Poulin ◽  
Elizabeth Avery ◽  
Ashvarya Mangla ◽  
Zeina Ibrahim ◽  
...  
Keyword(s):  
Physical Activity ◽  
Heart Failure ◽  
Cardiac Death ◽  
Physical Inactivity ◽  
Sedentary Time ◽  
Study Groups ◽  
Activity Time ◽  
Risk Of Death ◽  
Significant Difference ◽  
The Impact

Introduction: The impact of physical inactivity and sedentary time on heart failure (HF) outcomes in patients not participating in exercise program is unclear. Hypothesis: Physical inactivity and sedentary time are associated with worse HF outcomes. Methods: We analyzed data from the multicenter, HF Adherence and Retention Trial (HART) which enrolled 902 NYHA - II/III HF patients with preserved or reduced ejection fraction, followed for 36 months. Based on the mean weekly purposeful physical activity duration, patients were classified into inactive (0 min/wk), partially active (1-90 min/wk), and active (>90min/wk) groups. Patients were also classified according to average daily sedentary television (TV) time into <2 hrs/d, 2-4 hrs/d, and >4 hrs/d groups. Study groups were propensity score matched according to 33 baseline covariates in 1:1:1 ratio. The primary outcome was all-cause death. Secondary outcomes were cardiac death and HF hospitalization. Results: There were 196 inactive, 341 partially active and 365 active patients, of whom 492 (164 in each group) were successfully propensity matched. Physical inactivity was associated with higher risk of death and cardiac death than any level of physical activity, Fig 1. There was no significant difference in HF hospitalization. Furthermore, 465 subjects were propensity matched into three sedentary TV time groups (155 in each group). Sedentary TV time >4 hrs/d was independently and incrementally associated with all-cause death (Δ χ 2 = 6.05; P=0.049), beyond physical activity time, Fig 1. There was no significant difference in mortality between <2 and 2-4 hrs/d sedentary TV time groups, after adjusting to physical activity time, Fig 2. Conclusions: In symptomatic chronic HF patients, physical inactivity is associated with higher all-cause and cardiac mortality. Modest purposeful physical activity was associated with survival benefit. Extended sedentary time was associated incremental increased mortality.

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