Abstract 19793: Are Patients With Cardiac Resynchronization Therapy Living A More Active Life?
Background: Cardiac resynchronization therapy (CRT) as a treatment for heart failure has been demonstrated to decrease mortality, improve quality of life, and improve physical function. However, the effect of CRT on daily life activities has not yet been described. Objectives: To examine changes in daily physical activity and symptoms in heart failure patients with CRT.
Methods and Results: In a prospective multi-site study, 28 heart failure patients (66.7% male, 59.3 % Caucasian, mean LVEF= 29.6% + 12%, 74.1% NYHA Class III) were studied pre- and 3 months post- CRT implantation. Patients requiring additional surgical procedures or who were non-ambulatory were excluded. Measures included 6-minute walk test (6MWT), Daily Activity Questionnaire in Heart Failure (DAQIHF), Chronic Heart Failure Questionnaire (CHQ), Charleson Comorbidity Score, and device-based Activity Log data. Six-minute walk distance improved from baseline to 3 months post-implantation (288+177m, vs. post= 368+165m, p<.0001). Subjects reported a mean of 44.9+15.6% time pre-CRT vs. 41.08+12.6%post-CRT spent in low levels of daily physical activity. Subjects increased time in high levels of daily physical activity (mean=7.2+4.6% pre-CRT vs.12.8+3.8% post-CRT p=0.01). Even though subjects did not increase total daily energy expenditure or increase time spent in total daily physical activity along with no significant improvement in symptoms of dyspnea or fatigue, the device-based activity logs detected a mean of 8.7% time (over 2 hours) in daily physical activity. Moreover, subjects reported an increase in time spent in daily activities of > 3 METs.
Conclusions: In this sample, CRT patients were found to be more physically active at 3 months post-implant in those activities of > 3 METs, despite no reported improvement in symptoms of dyspnea and fatigue. These results suggest a closer examination of lifestyle factors post-CRT that may warrant recommendations for tailored cardiac rehabilitation and exercise prescription.
- © 2010 by American Heart Association, Inc.