Being active after receiving an implantable cardioverter-defibrillator could increase survival after the procedure, a recent American Heart Association study found.
The study, published May 15 in the Journal of the American Heart Association, is one of the largest on the connection between movement and mortality rates in patients who have ICDs, according to an AHA news release. Researchers looked at the amount of activity among patients within the first 30 to 60 days after their devices were implanted. They also tracked those patients for four years. Activity was defined as a walking speed of two miles per hour, the news release stated. Researchers used a nationwide database that included 98,437 patients who were part of a remote monitoring program. About 57% of the patients had received a new or replacement ICD and 43% received cardiac resynchronization therapy devices between 2008 and 2012.
Key findings in the study showed patients in the most active group had reduced their risk of death by 40%, compared to patients who had the least amount of activity, the news release said. The study also found that lower activity within the first 30 to 60 days of receiving the device transcended age, gender and device type — with patients having a 44% higher risk of death over time.
“We expected to see a difference, but we were struck by the magnitude of these results,” Daniel B. Kramer, MD, MPH, lead author of the study and assistant professor of medicine at Harvard Medical School in Boston said in the release. “Patients’ functional status clearly predicts survival. Our hope would be to use activity as a factor in not just predicting outcomes, but also to guide strategies that may improve outcomes. But that is much further down the line.”
ICDs are battery-operated gadgets placed under the skin near the shoulder with a wire inserted into the heart through the vein beneath the collarbone. The devices are extremely effective at finding like-threatening heart rhythm disorders and using timely shocks to correct the rhythms, according to the AHA release. The AHA notes that many patients with ICDs could still be at risk of death because of other underlying heart diseases or health issues.
The accessibility of information from ICDs could provide crucial prognostic data when deciding whether a patient should receive an ICD replacement, researchers noted in the study. Physicians might recommend an ICD for patients who are at risk of a life-threatening ventricular arrhythmia because of conditions such as a ventricular arrhythmia, a heart attack, having survived a sudden cardiac arrest, long QT syndrome, brugada syndrome and congenital heart disease or other underlying conditions for sudden cardiac arrest, according to the AHA.
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