Functional and Psychological Impact of Cardiac Rehabilitation in Patients With Implantable Cardiac Devices

Cardiac rehabilitation (CR) programs are established interventions for improving physical and psychological outcomes in patients with cardiovascular diseases. However, data on their effects in patients with cardiac implantable electronic devices (CIEDs), particularly in Latin America, remain limited.

To evaluate the impact of a structured CR program on functional capacity, psychological well-being, and clinical outcomes in patients undergoing CIED implantation.

This cohort study included 30 patients with CIEDs (pacemakers, implantable cardioverter defibrillators, or cardiac resynchronization therapy devices) enrolled in a CR program. Baseline assessments included the 6-minute walk test (6MWT), metabolic equivalents (METs), peak oxygen uptake (VO₂), left ventricular ejection fraction (LVEF), and Hospital Anxiety and Depression (HAD) scale scores. Patients completed a 12-week outpatient CR program, and outcomes were reassessed after program completion and at 1-year follow-up.

At baseline, the mean LVEF was 45.9% (±19.2), and the average 6MWT distance was 383.3 m (82.5% of predicted). Following CR, significant improvements were observed in 6MWT distance, METs, VO₂, LVEF, and HAD scale scores for anxiety and depression (p < 0.05). Subgroup analysis revealed improvements in functional capacity metrics for patients with pacemakers and CRT devices. Adverse events included one heart transplant in the ICD group and one death due to refractory heart failure in the CRT group.

CR programs significantly improve physical capacity, psychological well-being, and functional class in patients with CIEDs, with low complication rates.

This study is the first to evaluate the benefits of cardiac rehabilitation (CR) program for patients with cardiac implantable electronic devices (CIEDs) in a Latin American population. The CR programs significantly improve exercise capacity, left ventricular function, and anxiety/depression scores in patients with CIEDs. The CR programs are safe with low complication rates in patients with pacemakers and implantable cardioverter defibrillators. The study highlights the need for integrating CR into standard care for CIED patients to enhance functional and psychological outcomes.