Moderate exercise training improves functional capacity, quality of life, and endothelium-dependent vasodilation in chronic heart failure patients with implantable cardioverter defibrillators and cardiac resynchronization therapy

2006 ◽  
Vol 13 (5) ◽  
pp. 818-825 ◽  
Author(s):  
Romualdo Belardinelli ◽  
Francesco Capestro ◽  
Agostino Misiani ◽  
Pietro Scipione ◽  
Demetrios Georgiou
Keyword(s):  
Quality Of Life ◽  
Heart Failure ◽  
Cardiac Resynchronization ◽  
Implantable Cardioverter Defibrillators ◽  
Moderate Exercise ◽  
Resynchronization Therapy ◽  
Heart Failure Patients ◽  
Cardioverter Defibrillators ◽  
Moderate Exercise Training

Exercise training and cardiac rehabilitation in patients with implantable cardioverter defibrillators: a review of current literature focusing on safety, effects of exercise training, and the psychological impact of programme participation

2011 ◽  
Vol 19 (4) ◽  
pp. 804-812 ◽  
Author(s):  
Kjetil Isaksen ◽  
Ingvild Margreta Morken ◽  
Peter Scott Munk ◽  
Alf Inge Larsen
Keyword(s):  
Quality Of Life ◽  
Heart Failure ◽  
Exercise Training ◽  
Cardiac Rehabilitation ◽  
Current Literature ◽  
Control Group ◽  
Implantable Cardioverter Defibrillators ◽  
Increased Risk ◽  
Cardioverter Defibrillators

Background: Indications for implantable cardioverter defibrillators (ICDs) have been widened considerably during the last decade due to the well-documented effect in the heart failure population. Exercise training (ET) has a 1 A recommendation in heart failure. However, data on safety and efficacy of ET in patients with ICDs is sparse. ICD shocks are associated with reduced quality of life and increased mortality. Whether ET may have a beneficial effect in heart failure patients with an ICD is not well documented. Methods: This review is based on a systematic search in the Pub Med database using the terms ‘exercise training’, ‘implantable cardioverter defibrillator’, and ‘cardiac rehabilitation’. Results: Nine studies were identified, comprising 1889 patients. The average duration of exercise-based cardiac rehabilitation (CR) was 9.6 weeks. Ten ICD therapies (seven shocks) were reported in the 834 patients with ICD during ET. Between exercise sessions and during follow up 182 events were recorded including 166 shocks. Three studies (2 randomized) showed that the control group representing sedentary patients were more prone to ICD discharge than patients undergoing CR/ET. In all studies the ICD patients improved their aerobic fitness following ET. Few studies report data on the effect of ET on anxiety and depression. Conclusion: Based on the current literature, ET in patients with an ICD seems to be safe and is not associated with increased risk of shocks. ET improves aerobic capacity in ICD patients, while effects on anxiety, depression and quality of life are still under debate.

scholarly journals Implantable Cardioverter-Defibrillators and Cardiac Resynchronization Therapy in the Treatment of Heart Failure with Reduced Ejection Fraction

2017 ◽  
Vol 10 ◽  
Author(s):  
Ilaria Spoletini ◽  
Andrew Coats
Keyword(s):  
Heart Failure ◽  
Ejection Fraction ◽  
Cardiac Resynchronization Therapy ◽  
Cardiac Resynchronization ◽  
Implantable Cardioverter Defibrillators ◽  
Resynchronization Therapy ◽  
Device Therapy ◽  
Reduced Ejection Fraction ◽  
Patients With Heart Failure ◽  
Cardioverter Defibrillators

It has been long acknowledged that electrical-conduction disturbances may be both a cause of heart failure and a consequence of it. In fact, many patients with heart failure have an asynchronous contraction pattern of the heart muscle that further reduces the heart ability to pump blood. Electrical disturbances may therefore result in progressive left ventricular dysfunction, due to the added effects of HF-related electrical dyssynchrony. For this reason, device therapy may play a key role in the management of patients with heart failure and reduced ejection fraction (HFrEF). In particular, Implantable Cardioverter- Defibrillators (ICD) and Cardiac Resynchronization Therapy (CRT) may improve ejection fraction by reestablishing mechanical synchrony, possibly reversing symptoms and signs of heart failure, in addition to the more obvious role of ICD in terminating ventricular arrhythmias that threaten sudden death. Recommendations on device therapy from the current guidelines on heart failure management put out by the ESC/HFA in 2016 update our understanding of the evidence base for the use of ICD and CRT in HFrEF. We review these recommendations and the evidence behind them.

Abstract 3072: Beneficial Effects of Cardiac Resynchronization Therapy in Patients with Class Two Heart Failure

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Kristin E Ellison ◽  
Brad J Mikaelian ◽  
Karin F Hoth ◽  
Fausto G Devecchi ◽  
Athena Poppas ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Heart Failure ◽  
Cardiac Resynchronization Therapy ◽  
Nyha Class ◽  
Cardiac Resynchronization ◽  
Resynchronization Therapy ◽  
Significant Difference ◽  
Minute Walk

Cardiac resynchronization therapy (CRT) improves heart failure (HF) symptoms in patients (pts) with EF <35%, QRS >120ms, and NYHA class 3 and 4 HF. The aim of this study was to compare the effects of CRT in pts with EF <35%, QRS >130, and class 2 vs 3/4 HF. We enrolled 25 patients. All received ECGs, transthoracic echocardiograms, 6 minute walk tests, and Minnesota quality of life questionnaires pre-op and three months post-op. Fourteen pts were class 2, 10 patients were class 3, and 1 class 4. Ischemic cardiomyopathy accounted for 7 out of the 14 class 2 pts and 5 out of the 11 class 3/4 pts. As a group, all patients had a significant increase in 6 minute walk (1150 vs 1249, p=0.02), increase in EF (30% vs 39%, p<0.01), decreased QRS duration (162 vs 143, p=0.001), and improved quality of life scores (31.1 vs 21.7, p=0.03), comparing pre and post-op measurements. There was no significant difference in response of class 2 versus class 3/4 pts (see table ). Nonischemic pts had greater response than ischemic pts. Class 2 HF pts reported greater improvement in mental health than class 3 and 4. Younger patients reported greater functional improvement, while pts with higher BMI reported less physical benefit. Summary: Pts with NYHA class 2 symptoms derive similar hemodynamic benefit from CRT as pts with class 3/4 symptoms and may derive greater mental health benefits than class 3/4 pts. Comparison of Pre and Post-Implant Parameters Between Class 2 and 3/4 Patients

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