Physical Activity Measured by Implanted Devices Predicts Atrial Arrhythmias and Patient Outcome: Results of IMPLANTED (Italian Multicentre Observational Registry on Patients With Implantable Devices Remotely Monitored)

Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease

Giuseppe Boriani¹  Maria Zaccaria²  Michele Accogli²  Pietro Palmisano²  Federico Guerra³  Francesco Di Ubaldo³  Alessandro Capucci³  Giampiero Maglia⁴  Vittorio Aspromonte⁴  Ernesto Ammendola⁵  Gerardo Nigro⁵  Renato Pietro Ricci⁶  Eraldo Occhetta⁷  Gabriele Dell'Era⁷  Matteo Ziacchi⁸  Ennio Carmine Luigi Pisanò⁹ 

[1] Cardiology Department, University of Modena and Reggio Emilia Policlinico di Modena, Italy;Cardiology Unit “Card. G. Panico” Hospital, Tricase, Italy;Cardiology and Arrhythmology Clinic, Marche Polytechnic University University Hospital “Umberto I—Lancisi—Salesi,”, Ancona, Italy;Cardiology—Coronary Care Unit, Pugliese‐Ciaccio Hospital, Catanzaro, Italy;Department of Cardiology, Monaldi Hospital Second University of Naples, Italy;Department of Cardiovascular Diseases, San Filippo Neri Hospital, Rome, Italy;Division of Cardiology, University of Eastern Piedmont Maggiore della Carità Hospital, Novara, Italy;Institute of Cardiology, University of Bologna S.Orsola‐Malpighi University Hospital, Bologna, Italy;“Vito Fazzi” Hospital, Lecce, Italy;

关键词: atrial fibrillation;    heart failure;    implanted cardioverter defibrillator;    physical exercise;   

DOI  :  10.1161/JAHA.117.008146

来源: DOAJ

【 摘 要 】

BackgroundTo determine whether daily physical activity (PA), as measured by implanted devices (through accelerometer sensor), was related to the risk of developing atrial arrhythmias during long‐term follow‐up in a population of heart failure (HF) patients with an implantable cardioverter defibrillator (ICD). Methods and ResultsThe study population was divided into 2 equally sized groups (PA cutoff point: 3.5 h/d) according to their mean daily PA recorded by the device during the 30‐ to 60‐day period post‐ICD implantation. Propensity score matching was used to compare 2 equally sized cohorts with similar characteristics between lower and higher activity patients. The primary end point was time free from the first atrial high‐rate episode (AHRE) of duration ≥6 minutes. Secondary end points were: first AHRE ≥6 hours, first AHRE ≥48 hours, and a combined end point of death or HF hospitalization. Data from 770 patients (65±15 years; 66% men; left ventricular ejection fraction 35±12%) remotely monitored for a median of 25 months were analyzed. A PA ≥3.5 h/d was associated with a 38% relative reduction in the risk of AHRE ≥6 minutes (72‐month cumulative survival: 75.0% versus 68.1%; log rank P=0.025), and with a reduction in the risk of AHRE ≥6 hours, AHRE ≥48 hours, and the combined end point of death or HF hospitalization (all P<0.05). ConclusionsIn HF patients with ICD, a low level of daily PA was associated with a higher risk of atrial arrhythmias, regardless of the patients' baseline characteristics. In addition, a lower daily PA predicted death or HF hospitalization.

【 授权许可】

Unknown