Aerobic exercise prescription in heart failure patients with cardiac resynchronization therapy

Abstract

Cardiac resynchronization therapy (CRT) is indicated by the European Society of Cardiology (ESC) as a treatment given to patients with advanced heart failure, before consideration of heart transplantation. 1,2 There lies two main classification of CRT device, the default CRT-P (CRT-Pacemaker), and the addition of implantable cardioverter defibrillator (ICD), which form-up CRT-D (CRT-Defibrillator). One unique property of the CRT device is the presence of biventricular pacing system, in which CRT-D additionally allows the device to identify electrical activity in both ventricles and responds accordingly. Initial CRT candidate screening includes those diagnosed with heart failure, New York Heart Association (NYHA), functional class of III and IV, wide QRS segment (≥120 ms), and the presence of Left Bundle Branch Block (LBBB), which signifies cardiomyopathy. 1 Cardiologists would then determine which device is suitable for the patients' condition, in which the National Institute for Health and Care Excellence (NICE) guideline had clearly shown CRT-D is more indicated for those with wider QRS and NYHA functional class below IV, thus, showing better life expectancy. 3 The functional impact of CRT implantation has been reported to be satisfactory. It was shown that 59% of CRT patients will improve

Cardiac Rehabilitation in Patients with Pacemakers Implantation

“…7 Therapeutic exercise has consistently been shown to be safe and also effective in maintaining a better condition after pacemakers implantation. 8 In this patient, cardiac rehabilitation started after PPM insertion when the hemodynamic condition was stabilized. The initial phase of rehabilitation following pacemaker implantation typically begins 24 hours after the procedure.…”

“…7 Exercise may improve heart function through the effects of restoring peripheral circulation and has consistently been shown to be safe as well as effective in sustaining the changes affected by pacemakers. 8 Despite the importance of rehabilitation after pacemaker device implantation, there are limited specific guidelines available for this purpose. To determine an appropriate exercise program, it is crucial to conduct an exercise test.…”

“…7 Previous study consistently showed that therapeutic exercise was safe and effective in maintaining postpacemaker implantation condition. 8 The following case report discussed a rehabilitation program in 72 years old male patient with TAVB on TPM which was planned for PPM implantation. There were complications such as infection and displacement of TPM which caused pericardium perforation in the patient.…”

Research trends and hotspots in exercise rehabilitation for coronary heart disease: A bibliometric analysis

“…Long-term and stronger HIIT significantly improves exercise endurance [ 61 ] and has been shown to have fewer adverse effects in studies of heart failure. [ 62 ] Performing HIIT requires a personalized exercise program according to the patient functional status and exercise preferences to ensure safe rehabilitation while reducing physical discomfort.…”

A Bibliometric Analysis of High-Intensity Interval Training in Cardiac Rehabilitation

“…High-intensity interval training had a better impact than “continuous moderate exercise”, improving patients’ VO 2peak and aerobic capacity while reducing their cardiovascular mortality. High-intensity interval training programs that are longer in duration and higher in intensity can improve cardiovascular function and increase patients’ tolerance to exercise [ 56 ]. High-intensity interval training programs need to be tailored to the individual patient’s abilities and exercise habits in order to maximize compliance and safety while minimizing physiological discomfort [ 57 ].…”