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Aerobic exercise safe for patients with implantable defibrillators
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AHA Scientific Sessions 2011
ORLANDO, Fla. — New data suggest that 1 hour of walking daily does not increase serum B-type natriuretic peptide or heart failure symptoms in patients with an implantable cardioverter defibrillator.
“There has been concern about people with defibrillators exercising because of the potential for inducing arrhythmias, which could produce a shock from the ICD,” Gayle Flo, MN, ARNP, nurse practitioner and research nurse at the University of Washington School of Nursing in Seattle, told Cardiology Today. “In addition, there are limited clinical data about whether these patients can exercise safely.”
To determine the safety of exercise in this population, the researchers randomly assigned patients with ICDs to 8 weeks of aerobic conditioning or usual care. The intervention involved walking at 60% to 80% of maximum heart rate for 1 hour per day five times per week. They measured serum B-type natriuretic peptide (BNP) in a nonfasting state at baseline and after completion of the exercise program. Of the 117 patients included in the study, 61% were taking ACE inhibitors, 29% were using diuretics and all were taking beta-blockers. The researchers also noted that 8% had diabetes; 40% MI; 55% HF; and 29% hypertension.
Eighty-three percent of patients in the exercise group met the expected total days of walking per week and 99% met the exercise time requirement. No significant differences were observed between the usual care and the exercise groups (202.66 pg/dL vs. 222.34 pg/dL; P=.21).
At baseline, 51% of all patients had elevated BNP values, according to the researchers. Results showed, however, that those in the exercise group experienced a decrease from 273 pg/dL to 242 pg/dL whereas those in the usual-care group did not (236 pg/dL to 250 pg/dL).
“At this point, the data show that exercise at a fairly intense level for this population is safe, as far as inducing no effects on cardiac function, which we’ve determined by measuring BNP levels,” Flo said. “One of the next things that we’ll consider doing is trying to find the right dose of exercise for these patients and how to individualize the prescription of exercise for patients based on the different clinical characteristics that they might have.” – by Melissa Foster
For more information:
- Flo G. Poster #2054. Presented at: American Heart Association Scientific Sessions 2011; Nov. 12-16, 2011; Orlando, Fla.
Disclosure: Ms. Flo and colleagues report no relevant financial disclosures.
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