Key result
Low or declining physical activity post-ICD links to increased mortality, HF hospitalization, and shock risk.
Why the study?
ICD-embedded accelerometers capture physical activity, whereas wearable accelerometers can measure broader physical behavior including sleep, sedentary time, and rest-activity patterns in patients with an ICD or at high risk of sudden cardiac death.
Systematic Review (n=191,518)
Accelerometer-measured physical activity and its decline over time can serve as a prognostic marker for clinical deterioration, heart failure hospitalization, and ventricular arrhythmias in ICD recipients.
Answers are grounded in this paper and cite their sources.
Supports remote PA monitoring for risk stratification in ICD recipients; extends observational evidence linking activity decline to adverse outcomes.
Background: Current implantable cardioverter-defibrillator (ICD) devices are equipped with a device-embedded accelerometer capable of capturing physical activity (PA). In contrast, wearable accelerometer-based methods enable the measurement of physical behavior (PB) that encompasses not only PA but also sleep behavior, sedentary time, and rest-activity patterns. Objective: This systematic review evaluates accelerometer-based methods used in patients carrying an ICD or at high risk of sudden cardiac death. Methods: Papers were identified via the OVID MEDLINE and OVID EMBASE databases. PB could be assessed using a wearable accelerometer or an embedded accelerometer in the ICD. Results: A total of 52 papers were deemed appropriate for this review. Out of these studies, 30 examined device-embedded accelerometry (189,811 patients), 19 examined wearable accelerometry (1601 patients), and 3 validated wearable accelerometry against device-embedded accelerometry (106 patients). The main findings were that a low level of PA after implantation of the ICD and a decline in PA were both associated with an increased risk of mortality, heart failure hospitalization, and appropriate ICD shock. Second, PA was affected by cardiac factors (eg, onset of atrial fibrillation, ICD shocks) and noncardiac factors (eg, seasonal differences, societal factors). Conclusion: This review demonstrated the potential of accelerometer-measured PA as a marker of clinical deterioration and ventricular arrhythmias. Notwithstanding that the evidence of PB assessed using wearable accelerometry was limited, there seems to be potential for accelerometers to improve early warning systems and facilitate preventative and proactive strategies.
No takes yet. Share an insight, caveat, or question.
Kolk et al. (2021) conducted a systematic review in Implantable cardioverter-defibrillator (ICD) recipients or high risk of sudden cardiac death (n=191,518). Accelerometer-assessed physical behavior monitoring vs. High vs. low physical activity / Stable vs. declining physical activity was evaluated on Mortality, heart failure hospitalization, and appropriate ICD shock. A low level of physical activity after ICD implantation and a decline in physical activity were both associated with an increased risk of mortality, heart failure hospitalization, and ICD shock.
Synapse has enriched 10 related papers. Consider them for comparative context: