Association of time-varying changes in physical activity with cardiac death and all-cause mortality after ICD or CRT-D implantation
Xue-Rong SUN1
Chen-Di CHENG1
Bin ZHOU2
Shuang ZHAO1
Ke-Ping CHEN1
Wei HUA1
Yan-Gang SU3
Wei XU4
Fang WANG5
Xiao-Han FAN1
Yan DAI1
Zhi-Min LIU1
Shu ZHANG1
1.Arrhythmia Center,State Key Laboratory of Cardiovascular Disease,Fuwai Hospital,National Center for Cardiovas-cular Diseases,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing,China2.Department of Cardiology,Laboratory of Heart Center,Zhujiang Hospital,Southern Medical University,Guangzhou,China3.Department of Cardiology,Shanghai Institute of Cardiovascular Diseases,Zhongshan Hospital,Fudan University,Shanghai,China4.Department of Cardiology,Nanjing Drum Tower Hospital,Nanjing,China5.Department of Cardiology,Shanghai First People's Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai,China
摘要：OBJECTIVE To evaluate the association of longitudinal changes in physical activity (PA) with long-term outcomes after im-plantable cardioverter-defibrillator (ICD) or cardiac resynchronization therapy defibrillator (CRT-D) implantation. METHODS Patients with ICD/CRT-D implantation from SUMMIT registry were retrospectively analyzed. Accelerometer-de-rived PA changes over 12 months post implantation were obtained from the archived home monitoring data. The primary end-points were cardiac death and all-cause mortality. The secondary endpoints were the first ventricular arrthymia (VA) and first ap-propriate ICD shock. RESULTS In 705 patients, 446 (63.3％) patients showed improved PA over 12 months after implantation. During a mean 61.5-month follow-up duration, 99 cardiac deaths (14.0％) and 153 all-cause deaths (21.7％) occurred. Compared to reduced/un-changed PA, improved PA over 12 months could result in significantly reduced risks of cardiac death (improved PA ≤ 30 min:hazard ratio (HR) = 0.494, 95％ CI: 0.288?0.848; > 30 min: HR = 0.390, 95％ CI: 0.235?0.648) and all-cause mortality (improved PA ≤30 min: HR = 0.467, 95％CI: 0.299?0.728; > 30 min: HR = 0.451, 95％ CI: 0.304?0.669). No differences in the VAs or ICD shocks were observed across different groups of PA changes. PA changes can predict the risks of cardiac death only in the low baseline PA group, but improved PA was associated with 56.7％, 57.4％, and 62.3％ reduced risks of all-cause mortality in the low, moderate, and high baseline PA groups, respectively, than reduced/unchanged PA. CONCLUSIONS Improved PA could protect aganist cardiac death and all-cause mortality, probably reflecting better clinical efficacy after ICD/CRT-D implantation. Low-intensity exercise training might be encouraged among patients with different baseline PA levels.
机标关键词：associationactivityphysicalafterwithall-causecardiacchanges
论文发表日期：2022-03-28
在线出版日期：2025-08-15（本平台首次上网日期，不代表文献的发表时间）
页数：12( 177-188 )