Abstract 3879: Do ICD Patients Have Increased Adverse Events During Cardiac Rehabilitation? A Case Control Study
Introduction: Cardiac rehabilitation (CR) is beneficial in patients with cardiovascular disease. Recently, an increased number of patients with implantable cardioverter defibrillator (ICD) enroll in CR as indications for ICD expand. The purpose of this study is to assess adverse outcomes among patients with ICDs as compared to those without, when enrolled in a cardiac rehabilitation program.
Methods: All consecutive patients who had ICD implantation and subsequently enrolled in cardiac rehabilitation at Boston Medical Center or University of Vermont were identified as cases. Controls were patients enrolled in the same program, but did not have ICDs. Two groups were matched for age, gender and LVEF. The primary outcomes include frequency of ICD firings, cardiac arrests, hospitalizations, and death while at the CR center, or during the enrollment period. Secondary outcomes include changes in exercise capacity and compliance.
Results: Data are shown in the table⇓ below. 42 ICD patients and 42 controls were identified. Total hours of supervised exercise for each group were 828 and 925, respectively. Only two patients experienced ICD firings, one while at CR, the other outside of the center. There were no cardiac arrests and no deaths in either group. Hospitalization rates did not differ (1 ICD vs 0 control hospitalized directly from a CR facility; 3 ICD vs 1 control hospitalized during enrollment period, but outside of CR). Compliance with CR was similar with most dropouts for non-medical reasons. 15 patients from each group completed both entry and exit exercise tests (ETT) and demonstrated significant improvements in exercise capacity ( METs ) that was similar between groups.
Conclusion: The adverse event rate for ICD patients in CR is very low. These patients can attain similar improvements in exercise tolerance from CR as those without ICD.