Abstract 16249: Aerobic Exercise After an ICD Reduces Depression Severity and Improves Self-Efficacy to Exercise
Introduction: Aerobic exercise after an implantable cardioverter defibrillator (ICD) has been shown to be safe without provocation of arrhythmias. Effects of exercise on psychological outcomes and self-efficacy to exercise without fear of getting an ICD shock has not been consistently demonstrated.
Hypothesis: Completion of 8 weeks of home based aerobic exercise will reduce anxiety, depression, and increase self-efficacy to exercise with less of fear in getting an ICD shock.
Methods: 160 subjects (80/group) with a prior ICD implant (40% primary and 60% secondary prevention), mean age 55+12 years, 78% male, 84% Caucasian, 100% beta-blocked, and EF%=40%, completed a RCT comparing aerobic exercise to usual care (UC). Mean time since ICD implant=3.1 years. Aerobic exercise (EX)= 8 weeks of home walking 1 hour/day on 5 days/week at 60-80% of maximum HR using the Karvonen formula. Usual care =no change in exercise pattern. At baseline and 8 weeks participants completed questionnaires for state-trait anxiety (STAI), depression (PHQ-9), ICD fears (PCA), and self-efficacy to exercise (SEE). Analysis of variance controlling for age, bmi, gender, EF%, and Charlson score was used to determine group x time effects on study outcomes. Significance was p < 0.05.
Results: When compared to UC, aerobic exercise significantly reduced depression severity, p=0.05 (EX 1.38+.76, UC 1.50+.86), increased self-efficacy, p=0.05 (EX 7.6+ 1.93; UC 6.88+2.4), with a trend for reduction in ICD fears, p=0.09 (EX 6.12+9.2; UC 7.85+12.1). Exercise had no significant effect on anxiety, p=0.84 (EX 31.0+11.5; UC 31.2+10.4). Those in the EX group who got an ICD for secondary prevention accounted for the reduction seen in depression severity (F=4.58, p=0.03). Overall levels of anxiety and depression were not elevated in the sample.
Conclusions: While exercise has been shown to be safe and effective in improving functional capacity after an ICD, effects on psychological outcomes are inconsistent. Improved psychological outcomes, those that are discernable to patients, are likely to improve outcomes in other areas of living successfully with an ICD.
Author Disclosures: C.M. Dougherty: None. R. Burr: None. R. Glenny: None. P.J. Kudenchuk: None.
This research has received full or partial funding support from the American Heart Association.
- © 2014 by American Heart Association, Inc.