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Cardiovascular Rehabilitation With a WCD-Data From the CR3 Study (Cardiac Rehab Retrospective Review).


ABSTRACT:

Purpose

Patients at risk for sudden cardiac death may temporarily need a wearable cardioverter-defibrillator (WCD). Exercise-based cardiac rehabilitation (CR) has a class I recommendation in patients with cardiac disease. The aim of this study was to evaluate the safety and feasibility of undergoing CR with a WCD.

Methods

We performed a retrospective analysis of all patients with a WCD who completed a CR in Austria (2010-2020).

Results

Patients (n = 55, 60 ± 11 yr, 16% female) with a median baseline left ventricular ejection fraction (LVEF) of 36 (30, 41)% at the start of CR showed a daily WCD wearing duration of 23.4 (22, 24) hr. There were 2848 (8 [1, 26]/patient) automatic alarms and 340 (3 [1, 7]/patient) manual alarms generated. No shocks were delivered by the WCD during the CR period. One patient had recurrent hemodynamically tolerated ventricular tachycardias that were controlled with antiarrhythmic drugs.No severe WCD-associated adverse events occurred during the CR stay of a median 28 (28, 28) d. The fabric garment and the device setting needed to be adjusted in two patients to diminish inappropriate automatic alarms. Left ventricular ejection fraction after CR increased significantly to 42 (30, 44)% ( P < .001). Wearable cardioverter-defibrillator therapy was stopped due to LVEF restitution in 53% of patients. In 36% of patients an implantable cardioverter-defibrillator was implanted, 6% had LVEF improvement after coronary revascularization, one patient received a heart transplantation (2%), two patients discontinued WCD treatment at their own request (4%).

Conclusion

Completing CR is feasible and safe for WCD patients and may contribute positively to the restitution of cardiac function.

SUBMITTER: Rohrer U 

PROVIDER: S-EPMC10913858 | biostudies-literature | 2024 Mar

REPOSITORIES: biostudies-literature

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Publications

Cardiovascular Rehabilitation With a WCD-Data From the CR3 Study (Cardiac Rehab Retrospective Review).

Rohrer Ursula U   Reischl Anja A   Manninger Martin M   Binder Ronald K RK   Fiedler Lukas L   Gruska Michael M   Altenberger Johann J   Dorr Andreas A   Steinwender Clemens C   Stuehlinger Markus M   Wonisch Manfred M   Zirngast Birgit B   Zweiker David D   Zirlik Andreas A   Scherr Daniel D  

Journal of cardiopulmonary rehabilitation and prevention 20231130 2


<h4>Purpose</h4>Patients at risk for sudden cardiac death may temporarily need a wearable cardioverter-defibrillator (WCD). Exercise-based cardiac rehabilitation (CR) has a class I recommendation in patients with cardiac disease. The aim of this study was to evaluate the safety and feasibility of undergoing CR with a WCD.<h4>Methods</h4>We performed a retrospective analysis of all patients with a WCD who completed a CR in Austria (2010-2020).<h4>Results</h4>Patients (n = 55, 60 ± 11 yr, 16% fema  ...[more]

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