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A Novel Digital Platform for a Monitored Home-based Cardiac Rehabilitation Program
Published on: April 19, 2019
Exercise-based cardiac rehabilitation in cardiac resynchronization therapy recipients: A primer for practicing
Marco Ambrosetti1, Simona Sarzi Braga, Franco Giada
1Cardiovascular Rehabilitation Unit, Le Terrazze Clinic. m.ambrosetti@clinicaleterrazze.com.
Insights
Cardiac resynchronization therapy (CRT) enhances chronic heart failure (CHF) management. Exercise therapy (ET) alongside CRT improves functional capacity and cardiovascular prognosis in CHF patients undergoing cardiac rehabilitation.
Area of Science:
- Cardiology
- Rehabilitation Medicine
Background:
- Cardiac resynchronization therapy (CRT) is increasingly vital for chronic heart failure (CHF).
- A significant proportion of patients in cardiac rehabilitation (CR) programs now have CRT devices.
- CRT presence influences exercise prescription and monitoring within CR.
Purpose of the Study:
- To explore the role of exercise therapy (ET) in patients with CRT undergoing CR.
- To highlight the importance of tailoring ET programs for CRT patients.
- To review current evidence on exercise modalities for CHF patients with CRT.
Main Methods:
- Review of current literature on exercise therapy for CHF patients with CRT.
- Analysis of the impact of aerobic endurance and resistance training.
- Discussion of considerations for device programming and pacing limitations.
Main Results:
- Exercise therapy (ET) amplifies the benefits of CRT on functional capacity.
- ET may offer an adjuvant role in improving cardiovascular prognosis for CRT patients.
- Aerobic endurance and resistance training are suitable for CHF patients with CRT.
Conclusions:
- Tailored exercise programs are mandatory for CHF patients with CRT.
- Further research is needed on aerobic interval training in this population.
- Integrating ET with device management optimizes outcomes for CRT patients in CR.
Abstract:
Cardiac resynchronization therapy (CRT) is a therapeutic option of increasing importance for chronic heart failure (CHF) and criteria for implantation now concern a large amount of patient populations. As a consequence, subjects with ongoing CRT (or immediately after CRT implantation) are more often referred to Cardiac Rehabilitation (CR) programmes, and it has been recently estimated that about one third of CHF patients attending CR in Italy currently have this kind of device. The presence of CRT represents a modulating factor for exercise prescription and monitoring, since CRT patients may be considered per se as a target group for CR. Exercise therapy (ET) increases benefits from CRT on functional capacity, and recent evidence suggests an adjuvant role of ET in improving cardiovascular prognosis also. Both aerobic endurance and resistance training activities may involve CHF patients with CRT, while the potential role of aerobic interval training needs more studies and evidence. Prescription of an ET program should be associated with information regarding device programming and possible limiting factors associated with pacing therapy, tailoring of the basic principles of ET (in terms of type of exercise, intensity and program duration) in this patient group is mandatory.
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