Efficacy of Shoulder Rehabilitation Post-Cardiac Implantable Electronic Device Implantation

Background/Objectives: Cardiac implantable electronic devices (CIEDs) can prevent ventricular arrhythmia-related sudden cardiac death but cause paradoxical discomfort that impairs daily living and quality of life. No management guidelines exist for reducing pain, improving motion around the CIED implantation site, or preventing shoulder contractures. We evaluated the impact of continuous successive shoulder rehabilitation programs for CIED patients on reducing shoulder pain, improving shoulder range of motion, and patient satisfaction in daily living. Methods: In this prospective observational study, patients who had received CIED implantation underwent shoulder rehabilitation therapy with education during hospitalization from the day post-CIED implantation. After in-hospital rehabilitation, patients chose to undergo successive shoulder rehabilitation from their home and after 4 weeks in the outpatient clinic (rehabilitation group, n = 68) or not (non-rehabilitation group, n = 33). Pain and shoulder function was assessed using the Visual Analog Scale (VAS) and Disability of the Arm, Shoulder, and Hand (DASH) scores, respectively, the day following CIED implantation and at 1-3 months postoperatively. Patient satisfaction was evaluated using the 36-item Short Form Survey (SF-36). Outcomes were compared between groups. Results: VAS pain scores significantly decreased, while DASH scores substantially improved in the rehabilitation group compared to the non-rehabilitation group. Although the SF-36 subdomains were similar between groups, the rehabilitation group showed a better health-related quality of life trend. No complications were observed following post-CIED rehabilitation. Conclusions: Shoulder rehabilitation therapy with successive education after CIED implantation significantly improved pain and shoulder function. Definitive guidelines and long-term outcomes should be investigated further.