Abstract 2940: Maximising the Patient Benefit from Cardiac Resynchronisation Therapy can be Achieved by the Addition of Structured Exercise Training
Background: Cardiac Resynchronisation Therapy (CRT) has been proven to benefit suitable patients. Our hypothesis was that a structured exercise training programme in addition would maximise this benefit.
Methods: 44 patients referred for CRT were recruited. Patients were tested pre, 3 and 6 months post CRT. A modified Bruce protocol treadmill test was carried out to assess peak VO2, peak and resting Cardiac Power Output (CPO) and Cardiac Reserve (CR). Peak lower limb skeletal muscle torque was measured with a Biodex Isokinetic dynamometer. The percentage of Peak VO2 at Anaerobic Threshold (AT) was calculated using the V-slope method. Between the 3 and 6month tests, patients were randomised into an exercise (n = 22) or control group (n = 22). The exercise group underwent a exercise programme of 3 visits per week. Each session was made up of 20 mins of walking and 10 mins cycling. Paired t-tests were used to look for statistically significant differences.
Results: Pre CRT there was no significant differences between the groups. By 3 months both groups showed significant improvement in NYHA class, Exercise Duration, Peak VO2, Peak CPO, CR and Ejection Fraction. At this stage there was no change in the Percentage of Peak VO2 at AT and peak skeletal muscle torque. After randomisation the exercise group showed further improvements in all haemodynamic measures, ejection fraction, percentage of Peak VO2 at AT and in peak skeletal muscle torque. The control group showed no significant changes in Peak VO2, Peak CPO, CR, Ejection Fraction or skeletal muscle torque (see table 1⇓, results shown as mean (SE))
Conclusions: Exercise Rehabilitation leads to an improvement in both exercise haemodynamic measures and peak skeletal muscle torque in addition to the improvement seen after CRT. Therefore exercise rehabilitation allows greater benefit to be attained after CRT and should be considered for all patients.