Early Cardiac Rehabilitation Training Heart Rate Based on Low-Level Treadmill Testing After Myocardial Infarction and Before Hospital Discharge

1993 ◽  
Vol 13 (3) ◽  
pp. 194-200 ◽  
Author(s):  
Rudolph H. Dressendorfer ◽  
Barry A. Franklin ◽  
Joan L. Smith ◽  
Victoria Hollingsworth ◽  
Christopher DeWitt ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Heart Rate ◽  
Cardiac Rehabilitation ◽  
Hospital Discharge ◽  
Rehabilitation Training ◽  
Low Level ◽  
Treadmill Testing

scholarly journals Symptom-limited versus low level exercise testing before hospital discharge after myocardial infarction

1992 ◽  
Vol 20 (4) ◽  
pp. 927-933 ◽  
Author(s):  
Martin Juneau ◽  
Philippe Colles ◽  
Pierre Théroux ◽  
Pierre de Guise ◽  
Guy Pelletier ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Hospital Discharge ◽  
Exercise Testing ◽  
Low Level

Insufficient control of exercise intensity by heart rate monitoring in cardiac patients

2011 ◽  
Vol 19 (3) ◽  
pp. 436-443 ◽  
Author(s):  
Falko Frese ◽  
Philipp Seipp ◽  
Susanne Hupfer ◽  
Peter Bärtsch ◽  
Birgit Friedmann-Bette
Keyword(s):  
Heart Rate ◽  
Cardiac Rehabilitation ◽  
Exercise Intensity ◽  
Cardiac Patients ◽  
Treadmill Test ◽  
Exercise Tests ◽  
Self Monitoring ◽  
Volitional Exhaustion ◽  
Pulse Palpation ◽  
Treadmill Testing

Objectives: To test the reliability of heart rate (HR) recommendations for cardiac rehabilitation training obtained from different treadmill tests. Background: For training in cardiac rehabilitation, HR recommendations are derived from cardio-pulmonary tests. Exercise intensity is often controlled through self-monitoring HR by the cardiac patients. Design: Non-randomized clinical trial. Methods: 25 patients of a cardiac sports group (six women, 19 men, age 68.3 ± 5 years, height 171 ± 10 cm, weight 82 ± 12.8 kg) performed a stepwise increasing treadmill test according to a modified Stanford protocol (S) and a ramp treadmill test according to the Balke–Ware protocol (B) until volitional exhaustion. In 16 patients, HR was assessed with a HR monitor and compared with HR obtained by self-monitoring through pulse palpation during three training sessions. Results: Similar peak cardiopulmonary responses were obtained with the two exercise protocols of significantly ( p < 0.001) different duration (S 22:05 ± 7:11 min, B 13:31 ± 4:20 min). During the training sessions, HR exceeded the upper HR limit set at 85% HRpeak in 15 patients and in nine patients, higher HRpeak than in the exercise tests was observed. Five participants did not accurately measure their HR by pulse palpation. Conclusions: All but one patient of the cardiac sports group did not adhere to the HR recommendations derived from incremental treadmill testing, most likely because volitional exhaustion occurred in both treadmill tests before maximal cardiopulmonary responses were reached. In about 30% of the patients, training intensity could not be controlled by self-monitoring because of inaccurate pulse palpation.

scholarly journals Mechanisms of Exercise Capacity Improvement after Cardiac Rehabilitation Following Myocardial Infarction Assessed with Combined Stress Echocardiography and Cardiopulmonary Exercise Testing

2021 ◽  
Vol 10 (18) ◽  
pp. 4083
Author(s):  
Krzysztof Smarz ◽  
Tomasz Jaxa-Chamiec ◽  
Beata Zaborska ◽  
Maciej Tysarowski ◽  
Andrzej Budaj
Keyword(s):  
Myocardial Infarction ◽  
Heart Rate ◽  
Cardiac Rehabilitation ◽  
Exercise Capacity ◽  
Exercise Testing ◽  
Cardiopulmonary Exercise Testing ◽  
Oxygen Extraction ◽  
Peak Exercise ◽  
Cardiopulmonary Exercise ◽  
Peak Vo2

Cardiac rehabilitation (CR) is indicated in all patients after acute myocardial infarction (AMI) to improve prognosis and exercise capacity (EC). Previous studies reported that up to a third of patients did not improve their EC after CR (non-responders). Our aim was to assess the cardiac and peripheral mechanisms of EC improvement after CR using combined exercise echocardiography and cardiopulmonary exercise testing (CPET-SE). The responders included patients with an improved EC assessed as a rise in peak oxygen uptake (VO2) ≥ 1 mL/kg/min. Peripheral oxygen extraction was calculated as arteriovenous oxygen difference (A-VO2Diff). Out of 41 patients (67% male, mean age 57.5 ± 10 years) after AMI with left ventricular ejection fraction (LVEF) ≥ 40%, 73% improved their EC. In responders, peak VO2 improved by 27% from 17.9 ± 5.2 mL/kg/min to 22.7 ± 5.1 mL/kg/min, p < 0.001, while non-responders had a non-significant 5% decrease in peak VO2. In the responder group, the peak exercise heart rate, early diastolic myocardial velocity at peak exercise, LVEF at rest and at peak exercise, and A-VO2Diff at peak exercise increased, the minute ventilation to carbon dioxide production slope decreased, but the stroke volume and cardiac index were unchanged after CR. Non-responders had no changes in assessed parameters. EC improvement after CR of patients with preserved LVEF after AMI is associated with an increased heart rate response and better peripheral oxygen extraction during exercise.

Abstract 70: Participation in Cardiac Rehabilitation Is Associated with Reduced Rehospitalization Following Acute Myocardial Infarction

2013 ◽  
Vol 6 (suppl_1) ◽  
Author(s):  
Shannon M Dunlay ◽  
Victoria N Zysek ◽  
Quinn R Pack ◽  
Randal J Thomas ◽  
Jill M Killian ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Cardiac Rehabilitation ◽  
Hospital Discharge ◽  
Univariate Analysis ◽  
Billing Data ◽  
Post Discharge ◽  
Repeated Events ◽  
Reduced Risk

Background: Participation in cardiac rehabilitation (CR) has been shown to decrease mortality following acute myocardial infarction (MI), but its impact on rehospitalizations requires examination. Methods: We included patients who were hospitalized with first-ever MI in Olmsted County Minnesota from 1987-2010 and survived to hospital discharge. Participation in CR within the first 30 days following MI was determined using billing data and was analyzed as a time-dependent covariate. The association between CR participation and all-cause rehospitalization was analyzed using Andersen-Gill models to account for repeated events. As CR participation is a non-randomized intervention, we adjusted for propensity to participate after fitting a logistic regression model using 13 factors significantly associated with participation on univariate analysis. Patients were censored at the time of death or last follow-up. Results: Among 2991 patients (mean age 67 years, 59% male, 31% ST elevation MI), 1480 (49%) participated in CR following acute MI hospital discharge (first session occurred at a mean of 9 days post-discharge). Most patients (75%) were rehospitalized at least once during a mean follow-up of 7.6 years, and CR participation was associated with reduced risk of rehospitalization. The rehospitalization rates were 39% and 59% at one year for participants and non-participants, respectively. In unadjusted analysis, CR participation was associated with a markedly decreased risk of rehospitalization (HR 0.51, 95% CI 0.49-0.53, p<0.001). After adjusting for propensity to participate, the association between CR participation and all-cause rehospitalization persisted (HR 0.70, 95% CI 0.67-0.73, p<0.001). Conclusions: CR participation is associated with a markedly reduced risk of rehospitalization after incident MI. In addition to reducing mortality, improving CR participation rates may have a large impact post-MI healthcare resource use.

scholarly journals Regional Clinical Alliance Path and Cardiac Rehabilitation After Hospital Discharge for Acute Myocardial Infarction Patients in Japan　– A Nationwide Survey –

2016 ◽  
Vol 80 (8) ◽  
pp. 1750-1755 ◽  
Author(s):  
Tetsuo Arakawa ◽  
Leon Kumasaka ◽  
Michio Nakanishi ◽  
Masatoshi Nagayama ◽  
Hitoshi Adachi ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Cardiac Rehabilitation ◽  
Hospital Discharge ◽  
Nationwide Survey

scholarly journals See You in 7: improving acute myocardial infarction follow-up care

2018 ◽  
Vol 7 (2) ◽  
pp. e000296
Author(s):  
Alex Batten ◽  
Cassie Jaeger ◽  
David Griffen ◽  
Paula Harwood ◽  
Karen Baur
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Cardiac Rehabilitation ◽  
Hospital Discharge ◽  
Recovery Process ◽  
Appointment Scheduling ◽  
Academic Medical Centre ◽  
Number Of Patients ◽  
Follow Up Care

Acute myocardial infarction (AMI) follow-up care is a crucial part of the AMI recovery process. The American College of Cardiology’s ‘See You in 7 Challenge’ advocates that all patients discharged with a diagnosis of AMI have a cardiac rehabilitation referral made and outpatient cardiac rehabilitation appointment scheduled to occur within 7 days of hospital discharge. A streamlined AMI cardiac rehabilitation referral and appointment scheduling process was not in place at this urban academic medical centre. To develop the streamlined processes, a Six Sigma project was initiated. Four months before the intervention, 1/38 patients with AMI (2.6%) were scheduled to have the initial outpatient cardiac rehabilitation appointment occur within 7 days of hospital discharge, with an average 18.7 days from hospital discharge to the scheduled initial outpatient cardiac rehabilitation appointment. To reduce the time to this initial appointment, availability of outpatient cardiac rehabilitation appointments was increased, additional staff were trained in appointment scheduling and insurance verification processes and appointments were scheduled prior to hospital discharge. After intervention, the number of patients scheduled to attend an outpatient cardiac rehabilitation appointment within 7 days of hospital discharge improved to 72/79 (91.1%) (two-proportion test, p<0.001). Days from hospital discharge to first scheduled outpatient cardiac rehabilitation appointment were reduced from 18.7 days to 6.3 days (a 66.3% reduction) (Mann-Whitney U test, p<0.01). Initial outpatient cardiac rehabilitation attendance within 7 days of hospital discharge increased from 1/38 (2.6%) to 42/79 (53.2%) (a 50.6% increase) (two-proportion test, p<0.001).

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