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Updated: Jun 24, 2025
A Novel Digital Platform for a Monitored Home-based Cardiac Rehabilitation Program
Published on: April 19, 2019
Association Between Adherence to a 3-Month Cardiac Rehabilitation Program and Long-Term Clinical Outcomes in Japanese
Hidetoshi Yanagi1, Harumi Konishi, Katsuhiro Omae
1Authors Affiliations: Department of Cardiovascular Rehabilitation (Drs Yanagi, Yamamoto, and Murata), Department of Nursing (Ms Konishi), Data Science (Dr Omae), Department of Cardiovascular Medicine (Drs Murata, Ueda, Ishibashi, Noguchi, Kusano), National Cerebral and Cardiovascular Center, Suita, Japan.
Insights
Completing cardiac rehabilitation programs significantly lowers mortality risk for patients with cardiac implantable electronic devices. New strategies are needed to support patients who cannot complete these vital programs.
Area of Science:
- Cardiology
- Rehabilitation Medicine
- Medical Devices
Background:
- Cardiac implantable electronic devices (CIEDs) are crucial for managing heart conditions.
- Comprehensive cardiac rehabilitation (CCR) is recommended for improving outcomes in cardiovascular patients.
- The impact of CCR completion on long-term outcomes in CIED patients requires further investigation.
Purpose of the Study:
- To evaluate the association between completing comprehensive cardiac rehabilitation (CCR) and long-term clinical outcomes.
- To assess mortality risks in patients with cardiac implantable electronic devices (CIEDs) who participate in CCR.
Main Methods:
- Retrospective cohort study of 524 patients with CIEDs who underwent CCR.
- Eligibility criteria included specific left ventricular ejection fraction, predicted peak oxygen uptake, and B-type natriuretic peptide levels.
- Primary outcome was all-cause mortality, with a median follow-up of 3.7 years.
Main Results:
- 56% of referred patients completed the CCR program.
- Completers had significantly lower all-cause mortality rates compared to non-completers (log-rank P < .001).
- Adjusted analysis revealed a 58% lower risk of all-cause mortality for CCR completers (HR = 0.42; P < .001).
Conclusions:
- Completion of a 3-month CCR program is linked to reduced mortality in CIED patients.
- Development of new programs or management strategies is necessary to decrease mortality, particularly for non-completers.
Purpose:
The objective of this study was to evaluate the association between comprehensive cardiac rehabilitation (CCR) completion and long-term clinical outcomes in patients with cardiac implantable electronic devices (CIED).
Methods:
This retrospective cohort study included 834 patients with CIED who participated in CCR, which included a cardiopulmonary exercise test or 6-min walk test. Patients with a left ventricular ejection fraction ≤40%, predicted peak oxygen uptake ≤80%, or B-type natriuretic peptide level ≥80 pg/mL were eligible. The primary outcome was all-cause mortality.
Results:
After excluding 241 patients with duplicate records and 69 who underwent CCR in the outpatient department, the data of 524 patients were analyzed. Mean age was 64 ± 15 yr, 389 (74%) patients were men, left ventricular ejection fraction was 31 ± 15%, and 282 (54%) patients had a history of hospitalization for worsening heart failure. Of the patients referred for CCR, 294 (56%) completed the program, and an additional 230 patients started but did not complete CCR. Over a 3.7-yr median follow-up period, all-cause mortality occurred in 156 (30%) patients. Completers had lower all-cause mortality rates than non-completers (log-rank 15.77, P < .001). After adjusting for prognostic baseline characteristics, completers had 58% lower all-cause mortality risks than non-completers (HR = 0.42; 95% CI, 0.27-0.64, P < .001).
Conclusions:
Three-mo CCR program completion was associated with lower mortality risks in patients with CIED. New programs or management methods are needed to decrease mortality risks, especially for those who cannot complete CCR programs.
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