Response to Letter Regarding Article, “Prospective Randomized Trial of Moderately Strenuous Aerobic Exercise After an Implantable Cardioverter Defibrillator”
We thank Dr Ayoub for his questions about our recently published trial.1 In response to the first point, the difference between the usual care (UC) and exercise training and maintenance (EX) groups in their receipt of implantable cardioverter-defibrillator shocks was not statistically different during the study period. However, there were few implantable cardioverter-defibrillator shocks in both groups, limiting the power for this comparison. A slightly higher proportion of patients in the EX than in the UC group were taking antiarrhythmic medications at baseline study entry. The antiarrhythmic medication taken in both groups was amiodarone, with 1 person in the EX group also taking mexiletine. In response to the second point, patients were receiving a variety of β-blocker medications on study entry; these did not differ significantly between the EX and UC groups (atenolol, 3 in each group; bisoprolol, 1 in UC and 0 in EX; carvedilol, 36 in EX and 35 in UC; metoprolol, 31 in EX and 32 in UC; nebivolol, 0 in EX and 2 in UC; sotalol, 4 in EX and 3 in UC). Finally, when we stratified patients by implantable cardioverter-defibrillator indication (primary versus secondary), in primary prevention, there were 2 total shocks in 2 individuals: 1 shock in the UC group and 1 shock in the EX group. In secondary prevention, there were 10 total shocks: 7 shocks in 3 individuals in the UC group and 3 shocks in 2 individuals in the EX group. These differences were not statistically significant.
Cynthia M. Dougherty, RN, ARNP, PhD
Biobehavioral Nursing and Health Systems University of Washington School of Nursing Seattle, WA Department of Medicine Division of Cardiology University of Washington School of Medicine Seattle, WA
Robb W. Glenny, MD
Departments of Medicine and Physiology and Biophysics Division of Pulmonary and Critical Care University of Washington School of Medicine Seattle, WA
Robert L. Burr, PhD
Biobehavioral Nursing and Health Systems University of Washington School of Nursing Seattle, WA
Gayle L. Flo, ARNP, MN
Mayo Clinic Division of Cardiovascular Diseases Rochester, MN
Peter J. Kudenchuk, MD
Department of Medicine Division of Cardiology University of Washington School of Medicine Seattle, WA
- © 2015 American Heart Association, Inc.