Physical activity and mortality in older patients with a pacemaker

Goto, Toshihiko; Mori, Kento; Nakasuka, Kosuke; Kato, Marina; Nakayama, Takafumi; Banno, Tomoyuki; Ichihashi, Taku; Wakami, Kazuaki; Fukuta, Hidekatsu; Seo, Yoshihiro; Ohte, Nobuyuki

doi:10.1111/ggi.13823

Cited by 5 publications

(12 citation statements)

References 20 publications

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“…However, in those studies, PA was based on questionnaires with low accuracy or a wearable device with a short detection period. In contrast, our study was conducted in patients at high risk of SCD risk with ICDs/CRTDs that had continuous PA recording function [19,25]. HM technology allowed the instantaneous transmission of stored device data and enabled the continuous and longer acquisition of PA data.…”

Section: Discussionmentioning

confidence: 99%

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Dose-response association of implantable device-measured physical activity with long-term cardiac death and all-cause mortality in patients at high risk of sudden cardiac death: a cohort study

Zhao

Chen

et al. 2020

Int J Behav Nutr Phys Act

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Background Cardiovascular implantable electronic devices (CIEDs) with physical activity (PA) recording function can continuously and automatically collect patients’ long-term PA data. The dose-response association of implantable cardioverter-defibrillator (ICD) and cardiac resynchronization therapy defibrillator (CRTD)-measured PA with cardiovascular outcomes in patients at high risk of sudden cardiac death (SCD) was investigated. Methods In total, 822 patients fulfilling the inclusion criteria were included and divided into three groups according to baseline PA tertiles: tertile 1 (< 8.04%, n = 274), tertile 2 (8.04–13.24%, n = 274), and tertile 3 (> 13.24%, n = 274). The primary endpoint was cardiac death, the secondary endpoint was all-cause mortality. Results During a mean follow-up of 59.7 ± 22.4 months, cardiac death (18.6% vs 8.8% vs 5.5%, tertiles 1–3, P < 0.001) and all-cause mortality (39.4% vs 20.4% vs 9.9%, tertiles 1–3, P < 0.001) events decreased according to PA tertiles. Compared with patients younger than 60 years old, older patients had a lower average PA level (9.6% vs 12.8%, P < 0.001) but higher rates of cardiac death (13.2% vs 8.1%, P = 0.024) and all-cause mortality (28.4% vs 16.7%, P < 0.001) events. Adjusted multivariate Cox regression analyses showed that a higher tertile of PA was associated with a lower risk of cardiac death (hazard ratio (HR) 0.41, 95% confidence interval (CI): 0.25–0.68, tertile 2 vs tertile 1; HR 0.28, 95% CI: 0.15–0.51, tertile 3 vs tertile 1, Ptrend < 0.001). Similar results were observed for all-cause mortality. The dose-response curve showed an inverse non-linear pattern, and a significant reduction in endpoint risk was observed at the low-moderate PA level. The HR for cardiac death was reduced by half with 12.32% PA (177 min), and the HR for all-cause mortality was reduced by half with 11.92% PA (172 min). Subgroup analysis results indicated that older adults could benefit from PA and the range for achieving optimal benefits might be lower. Conclusions PA monitoring may aid in long-term management of patients at high risk of SCD. More PA will generate better survival benefits, but even low-moderate PA is already good especially for older adults, which is relatively easy to achieve.

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Section: Discussionmentioning

confidence: 99%

“…The time during which the motion sensors of the Biotronik devices delivered rates higher than the devices' basic rates was recorded. The accuracy of PA measurement has been validated with treadmill test [19]. The PA resolution was 2 s, and the data were converted into % per 24 h. For example, 10% PA indicated 2.4 h of daily PA.…”

Section: Pa Recordingmentioning

confidence: 99%

Dose-response association of implantable device-measured physical activity with long-term cardiac death and all-cause mortality in patients at high risk of sudden cardiac death: a cohort study

Zhao

Chen

et al. 2020

Int J Behav Nutr Phys Act

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Methods

PatientsThe retrospective study was conducted in 323 consecutive patients who underwent CIED implantation between January 2014 and December 2018. CIEDs were defined as pacemakers and high-voltage devices, such as implantable cardioverter defibrillators, cardiac resynchronization

…”

mentioning

confidence: 99%

“…physical activity time, which was determined by pacemakers after implantation, was associated with mortality. 7 To our knowledge, however, no study has investigated both life expectancy and the frequency of hospitalization due to HF after several types of CIED in these patients, and data in support of decision making are unavailable.…”

mentioning

confidence: 99%

“…5 The aging of populations worldwide has been accompanied by a marked increase in the use of CIEDs. 6, 7 However, CIED usage in aged patients is generally performed without regard to performance of activities of daily living (ADL), and thus recipients often include patients with poor ability to perform ADLs, such as those with a high Clinical Frailty Score (CFS). 3 A comprehensive understanding of prognosis in these patients would facilitate decision making on the indications for a CIED, and improve postimplantation management and outcomes.…”

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confidence: 99%

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Clinical Frailty Score Predicts Long-Term Mortality and Hospitalization Due to Heart Failure After Implantation of Cardiac Implantable Electric Device

Matsuda

Masuda

Asai

et al. 2021

Circ J

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physical activity time, which was determined by pacemakers after implantation, was associated with mortality. 7 To our knowledge, however, no study has investigated both life expectancy and the frequency of hospitalization due to HF after several types of CIED in these patients, and data in support of decision making are unavailable.Here, as part of efforts to establish indications for CIED treatment in aged patients with low ADL status, we investigated the association between CFS and prognosis in patients with a CIED. Methods PatientsThe retrospective study was conducted in 323 consecutive patients who underwent CIED implantation between January 2014 and December 2018. CIEDs were defined as pacemakers and high-voltage devices, such as implantable cardioverter defibrillators, cardiac resynchronization

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Implantable device measured objective daily physical activity as a predictor of long-term all-cause mortality and cardiac death in patients with age > 75 years and high risk of sudden cardiac death: a cohort study

Chen

Hua

et al. 2022

BMC Geriatr

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Background To study the relationship between objective daily physical activity (PA), as measured by implantable cardioverter defibrillators (ICDs)/cardiac resynchronization therapy defibrillators (CRTDs), and long-term prognoses in patients with age > 75 years at high risk of sudden cardiac death (SCD). Methods In total, 133 patients with age > 75 years old (age 79.52 ± 3.68 years) in the SUMMIT study were retrospectively analysed. The major endpoint was all-cause mortality, and the minor endpoint was cardiac death. Results The mean follow-up time was 57.1 ± 24.2 months (range: from 4 to 96 months). In total, 46 all-cause mortality and 23 cardiac death events occurred. The receiver operating characteristic curve indicated a baseline PA cut-off value of 6.47% (93 min/day) can predict all-cause mortality in patients with age > 75 years, with an area under the curve of 0.670 (95% confidence interval (CI): 0.573–0.767, P = 0.001). The sensitivity was 67.4%, and the specificity was 66.7%. Patients with baseline PA ≤ 6.47% had higher rates of all-cause mortality (51.7% vs 20.5%, P < 0.001) and cardiac death (25.0% vs 11.0%, P = 0.040). The estimated Kaplan-Meier survival curves showed that patients with PA ≤ 6.47% had an increased cumulative incidence of all-cause mortality (Log-rank P < 0.0001) and cardiac death (Log-rank P = 0.0067). Multivariate Cox regression analysis showed that PA ≤ 6.47% was an independent predictor of all-cause mortality (hazard ratio (HR) 3.137, 95% CI: 1.667–5.904, P < 0.001) and cardiac death (HR value 3.345, 95% CI: 1.394–8.028, P = 0.007). Conclusions Daily PA of about 1.5 h was associated with lower all-cause mortality and cardiac death risk in patients with age > 75 years and high risk of SCD with ICDs/CRTDs. PA monitoring may aid in long-term management of older patients at high risk of SCD.

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Physical activity and mortality in older patients with a pacemaker

Cited by 5 publications

References 20 publications

Dose-response association of implantable device-measured physical activity with long-term cardiac death and all-cause mortality in patients at high risk of sudden cardiac death: a cohort study

Dose-response association of implantable device-measured physical activity with long-term cardiac death and all-cause mortality in patients at high risk of sudden cardiac death: a cohort study

Clinical Frailty Score Predicts Long-Term Mortality and Hospitalization Due to Heart Failure After Implantation of Cardiac Implantable Electric Device

Implantable device measured objective daily physical activity as a predictor of long-term all-cause mortality and cardiac death in patients with age > 75 years and high risk of sudden cardiac death: a cohort study

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