Neuromuscular electrical stimulation of the thighs in cardiac patients with implantable cardioverter defibrillators

Abstract

SummaryBackgroundThe aim of this systematic review was to update scientific knowledge concerning the safety of neuromuscular electrical stimulation (NMES) to increase exercise capacity and prevent cardiac cachexia in patients with implantable cardioverter defibrillators (ICDs).MethodsA systematic review including the electronic databases PubMed, MEDLINE, and SCOPUS was conducted for the time period from 1966 to March 31, 2016.ResultsOnly four articles fulfilled the inclusion criteria (three original articles/safety studies and one case report). The three (safety) studies used NMES to increase muscle strength and/or endurance capacity of the thighs. NMES did not show electromagnetic interference (EMI) with ICD function. EMI was described in a case report of 2 patients with subpectoral ICDs and application of NMES on abdominal muscles.ConclusionThis review indicates that NMES may be applied in cardiac ICD patients if 1) individual risks (e. g., pacing dependency, acute heart failure, unstable angina, ventricular arrhythmic episode in the last 3 months) are excluded by performing a safety check before starting NMES treatment and 2) “passive” exercise using NMES is performed only for thighs and gluteal muscles in 3) compliant ICD patients (especially for home-based NMES) and 4) the treatment is regularly supervised by a physician and the device is examined after the first use of NMES to exclude EMI. Nevertheless, further studies including larger sample sizes are necessary to exclude any risk when NMES is used in this patient group.

Neuromuscular electrical stimulation is feasible in patients with acute heart failure

“…As another mechanism that induces arrhythmias, it is also necessary to evaluate whether NMES directly stimulates the heart or interferes with the pacemakers because implantable cardioverter defibrillators and pacemakers were implanted in several patients with AHF . As in a previous report, electromagnetic interference was not observed in intracardiac electrocardiogram in our study, indicating that NMES can be safely used in patients with AHF wearing these devices.…”

The efficacy and prescription of neuromuscular electrical stimulation (NMES) in adult cancer survivors: a systematic review and meta-analysis

“…Although this prescription has been successful and safe in other patient groups (i.e. COPD, CHF), including those with implantable cardioverter defibrillators (when delivered to lower imbs) [45,46], such a general approach in cancer survivors may mask NMES's potential, given that cancer survivors can experience day to day variability in their readiness to train. The prescription of voluntary exercise in cancer survivorship is mostly individualised and adapted to optimise the therapeutic effect and minimise injury [47].…”

Personalised and progressive neuromuscular electrical stimulation (NMES) in patients with cancer—a clinical case series

“…Patients were excluded if; 1) they had serious cardiac arrhythmias, 2) any cognitive impairment which may affect their ability to apply NMES safely unsupervised, 3) deep vein thrombosis within the last 6 months, or 4) metastatic lesions to the femur. Although a cardiac pacemaker is considered a contraindication, emerging evidence suggests patients with a pacemaker can use lower limb NMES safely [21]. Therefore, pacemaker patients were considered if given clearance from their cardiologist.…”