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Sex differences in device-measured physical activity after transcatheter aortic valve replacement.

Anthony J Mazzella, Anil K Gehi, Ryan Searcy

  • 1Division of Cardiology, Department of Medicine, University of North Carolina Hospitals, CB 7075, 160 Dental Circle, 6025 Burnett-Womack Bldg., Chapel Hill, NC 27599-7075. lindsey_rosman@med.unc.edu.

The Journal of Invasive Cardiology
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Summary

Transcatheter aortic valve replacement (TAVR) significantly increases daily physical activity (PA) in patients with cardiac implanted electronic devices (CIEDs). This improvement in PA is more pronounced in women than men, suggesting TAVR benefits functional outcomes.

Keywords:
pacemakerTranscatheter aortic valve replacementactivitydefibrillator

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Area of Science:

  • Cardiovascular Medicine
  • Medical Devices
  • Rehabilitation

Background:

  • Physical activity (PA) is a critical determinant of clinical outcomes and quality of life following transcatheter aortic valve replacement (TAVR).
  • Patients with cardiac implanted electronic devices (CIEDs) represent a specific population undergoing TAVR, whose functional recovery warrants investigation.
  • Objective measurement of PA using data from CIEDs offers a robust method to assess post-procedural recovery.

Purpose of the Study:

  • To evaluate the impact of TAVR on objectively measured physical activity (PA) in patients equipped with cardiac implanted electronic devices (CIEDs).
  • To compare changes in PA levels before and after TAVR.
  • To investigate potential sex-based differences in PA response to TAVR.

Main Methods:

  • Utilized daily accelerometer data from CIEDs to quantify PA in patients undergoing TAVR.
  • Included patients with at least six months of pre-TAVR and twelve months of post-TAVR PA data.
  • Employed linear mixed-effects models to analyze changes in PA, incorporating an interaction term to assess sex differences.

Main Results:

  • A significant and sustained increase in daily PA of 14.7% (10.15 minutes/day) was observed post-TAVR.
  • The positive effect of TAVR on PA was significantly more pronounced in women (18.57 minutes/day increase) compared to men (4.51 minutes/day increase).
  • These findings remained significant after adjusting for covariates including sex, obesity, race, depression history, and Charlson Comorbidity Index.

Conclusions:

  • TAVR leads to a substantial increase in objectively measured physical activity, indicating improved functional status.
  • Women experience a greater benefit in terms of PA improvement following TAVR compared to men.
  • Remote monitoring data from CIEDs can effectively track functional recovery and outcomes in patients post-TAVR.