TY - JOUR

T1 - Physical Activity in Primary Versus Secondary Prevention Indication Implantable Cardioverter Defibrillator Recipients 6–12 Months After Implantation – A Cross-Sectional Study With Register Follow Up

AU - Berg, Selina Kikkenborg

AU - Thygesen, Lau Caspar

AU - Svendsen, Jesper Hastrup

AU - Christensen, Anne Vinggaard

AU - Zwisler, Ann-Dorthe

N1 - Copyright © 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

PY - 2015/3

Y1 - 2015/3

N2 - OBJECTIVES: To describe physical activity status among patients with implantable cardioverter defibrillators (ICDs) according to the indication for ICD implant compared with international guidelines and compared with a matched healthy reference population to detect potential for improved physical outcomes; to describe patients' beliefs regarding participation in physical exercise by ICD indication; to describe factors predicting low physical activity; and to describe physical activity as a predictor of mortality.DESIGN: National survey with register follow-up. Comparisons were made to a matched healthy reference population, and patients were followed in registers for 15 months.SETTING: Patients are identified from national registers and questionnaires are distributed by postal mail.PARTICIPANTS: All diagnostic profiles and indications were included as were both single-chamber ICD and biventricular ICD (N=499).INTERVENTIONS: Not applicable.MAIN OUTCOME MEASURES: Questions regarding physical activity and the International Physical Activity Questionnaire-Short Form were used to assess physical activity.RESULTS: The response rate was 71.7%. The mean age of participants was 65.5 years, with 82% of participants being men. Of the participants, 37% participated in a rehabilitation program, and 21% were sedentary compared with 8% in the reference population (P<.0001). Only 13% of patients followed physical exercise guidelines. Low physical activity was predicted by primary prevention indication (odds ratio [OR]=2.5; 95% confidence interval [CI], 1.3-4.7) and higher comorbidity (OR=2.1; 95% CI, 1.0-4.1; P<.05). Finally, low physical activity was associated with increased mortality (OR=3.9; 95% CI, 1.11-13.71; P<.05); however, it was not statistically significant when adjusted for age, sex, marital status, and comorbidity.CONCLUSIONS: Guidelines for exercise and participation in rehabilitation are not met for this population, leaving a great potential for future interventions to improve the clinical outcomes, which are modifiable by exercise.

AB - OBJECTIVES: To describe physical activity status among patients with implantable cardioverter defibrillators (ICDs) according to the indication for ICD implant compared with international guidelines and compared with a matched healthy reference population to detect potential for improved physical outcomes; to describe patients' beliefs regarding participation in physical exercise by ICD indication; to describe factors predicting low physical activity; and to describe physical activity as a predictor of mortality.DESIGN: National survey with register follow-up. Comparisons were made to a matched healthy reference population, and patients were followed in registers for 15 months.SETTING: Patients are identified from national registers and questionnaires are distributed by postal mail.PARTICIPANTS: All diagnostic profiles and indications were included as were both single-chamber ICD and biventricular ICD (N=499).INTERVENTIONS: Not applicable.MAIN OUTCOME MEASURES: Questions regarding physical activity and the International Physical Activity Questionnaire-Short Form were used to assess physical activity.RESULTS: The response rate was 71.7%. The mean age of participants was 65.5 years, with 82% of participants being men. Of the participants, 37% participated in a rehabilitation program, and 21% were sedentary compared with 8% in the reference population (P<.0001). Only 13% of patients followed physical exercise guidelines. Low physical activity was predicted by primary prevention indication (odds ratio [OR]=2.5; 95% confidence interval [CI], 1.3-4.7) and higher comorbidity (OR=2.1; 95% CI, 1.0-4.1; P<.05). Finally, low physical activity was associated with increased mortality (OR=3.9; 95% CI, 1.11-13.71; P<.05); however, it was not statistically significant when adjusted for age, sex, marital status, and comorbidity.CONCLUSIONS: Guidelines for exercise and participation in rehabilitation are not met for this population, leaving a great potential for future interventions to improve the clinical outcomes, which are modifiable by exercise.

KW - Activities of Daily Living

KW - Aged

KW - Cross-Sectional Studies

KW - Defibrillators, Implantable

KW - Denmark

KW - Exercise

KW - Female

KW - Follow-Up Studies

KW - Guideline Adherence

KW - Heart Diseases

KW - Humans

KW - Male

KW - Middle Aged

KW - Practice Guidelines as Topic

KW - Primary Prevention

KW - Registries

KW - Secondary Prevention

KW - Surveys and Questionnaires

U2 - 10.1016/j.apmr.2014.11.001

DO - 10.1016/j.apmr.2014.11.001

M3 - Journal article

C2 - 25448249

VL - 96

SP - 426

EP - 431

JO - Archives of Physical Medicine and Rehabilitation

JF - Archives of Physical Medicine and Rehabilitation

SN - 0003-9993

IS - 3

ER -