Abstract 13965: Aerobic Exercise After an ICD: Results of the Psychological and Quality of Life Outcomes in the Anti-Arrhythmic Effects of Exercise After an ICD Trial
Introduction: The Anti-Arrhythmic Effects of Exercise Trial reported aerobic exercise training for 8-24 weeks after an implantable cardioverter defibrillator (ICD) significantly improved cardiopulmonary function. The purpose of this report is to outline the 8 and 24 week quality of life and psychological outcomes of the trial.
Methods: 160 subjects with a prior ICD implant (40% primary and 60% secondary prevention), mean age 55 ±12 years, 77.5% male, 84% Caucasian, 100% beta-blocked, and EF%=40%, entered a RCT comparing aerobic exercise (EX) to usual care (UC). EX= aerobic training x 8 weeks of home walking 1 hour/day on 5 days/week at 60-80% of maximum HR, followed by aerobic maintenance x 16 weeks of home walking for 150 min/week. At baseline, 8 and 24 weeks, participants completed questionnaires: Quality of Life (SF-36), Anxiety (State-Trait Anxiety Inventory), Depression (PHQ-9), and Symptoms (Patient Concerns Assessment). Adherence to exercise was tracked with Polar HR monitors and pedometers. Analysis of variance was used to determine group x time effects on study outcomes and by adherence groups.
Results: There were no differences noted between EX and UC on quality of life, symptoms, or anxiety at 8 or 24 weeks using intent-to-treat. There was a significant reduction in depression severity between EX vs UC at 8 weeks (p=0.05). When comparing those who exercised at ≥80% (N=48) to <80% (N=36) and UC (N=76), there were statistically significant improvements in quality of life [positive health transition, (p=0.006) and social function (p=0.03)], with a reduction in fear of dying (p=0.04), anxiety (p=0.02), and depression severity (p=0.04) at 8 weeks in those who exercise at ≥80%. Those who continued to exercise at ≥80% for 16 more weeks, had a significant continued improvement in quality of life [positive health transitions (p=0.006), physical function (p=0.01), vitality (p=0.04), social function (p=0.03), and role emotional (p=0.02)], while anxiety (p=0.002) and symptoms (p=0.003) were reduced. Depression by adherence groups at 24 weeks was unchanged.
Conclusions: Aerobic exercise training and maintenance for those who actually exercised as prescribed, had benefits in improved quality of life, with reductions in symptoms and psychological distress.
Author Disclosures: C.M. Dougherty: None. R.L. Glenny: None. P.J. Kudenchuk: None. R.L. Burr: None.
- © 2016 by American Heart Association, Inc.