Exercise programs for LVAD supported patients: A snapshot from the ESC affiliated countries.

Area of Science:

• Cardiology
• Rehabilitation Medicine
• Exercise Physiology

Background:

• Left Ventricular Assist Device (LVAD) implantation is a critical intervention for advanced heart failure.
• Optimizing patient outcomes requires comprehensive post-implantation care, including structured exercise.
• Standardized exercise training protocols are essential for LVAD-supported individuals.

Purpose of the Study:

• To review existing exercise training programs (ETPs) for LVAD patients in ESC-affiliated countries.
• To identify variations and gaps in current ETPs to inform protocol development.
• To contribute to establishing best practices for exercise rehabilitation in LVAD recipients.

Main Methods:

• Analysis of data from a subset of 77 LVAD implanting centers across 26 countries.
• Data collected from the broader Extra-HF survey involving 170 centers.
• Focus on the characteristics and components of established ETPs for LVAD patients.

Main Results:

• 58% of LVAD centers offer a functioning ETP, with significant variability in program structure and content.
• ETPs often commence during in-hospital recovery (47%), with most offering early post-discharge (71%) and some long-term maintenance (24%) programs.
• Commonly included components are aerobic training (84%), resistance training (47%), and respiratory muscle training (55%), primarily delivered by physiotherapists.

Conclusions:

• A considerable heterogeneity exists in ETPs provided by LVAD implanting centers.
• The absence of universal ETPs and the reliance on localized protocols highlight a need for standardized guidance.
• Further evidence is required to define optimal exercise modalities for LVAD-supported patients.