Key result
Device-measured physical activity combined with other parameters demonstrated modest-to-good sensitivity in predicting acute heart failure decompensation, hospitalization, and mortality in 7 studies.
Why the study?
Can device-measured physical activity (D-PA) from cardiovascular implantable electronic devices predict clinical outcomes such as heart failure decompensation, hospitalization, and mortality?
Systematic Review (n=29)
Can device-measured physical activity (D-PA) from cardiovascular implantable electronic devices predict clinical outcomes such as heart failure decompensation, hospitalization, and mortality?
Device-measured physical activity from implantable cardiac devices shows promise in predicting clinical outcomes like heart failure decompensation when combined with other parameters, though methodological standardization is needed.
May aid early HF event detection via wearables; extends observational data but requires randomized validation before practice change.
BACKGROUND: Physical activity is predictive of cardiovascular outcomes in patients with cardiovascular implantable electronic devices, yet it is not regularly assessed in routine care. Current-generation cardiovascular implantable electronic devices, however, continuously monitor patient activity through a built-in accelerometer, which provides new opportunities to remotely assess patient activity, detect changes in clinical status, and incorporate these data in risk stratification models. This review critically examines the literature on device-measured physical activity (D-PA), with a focus on identifying methodological issues that may affect interpretation of study results. METHODS AND RESULTS: We conducted a systematic review of D-PA studies published from January 1 1995 to December 30 2017, identifying 29 studies meeting inclusion criteria, 5 of which were validation reports. Few technical details about D-PA sensors are reported, and procedures for analyzing and interpreting D-PA data are heterogeneous. Trends in D-PA over time and associations with clinical outcomes were reported by 22 studies, and in 7 studies, D-PA was combined with other device parameters in risk stratification models, demonstrating modest-to-good sensitivity in predicting acute heart failure decompensation, hospitalization, and mortality. CONCLUSIONS: Current evidence suggests that D-PA may be useful for assessing physical activity and predicting clinical outcomes in patients with cardiovascular implantable electronic devices when combined with other device parameters. Future work must address challenges related to D-PA data measurement, interpretation, and generalizability to support expanded clinical applications of this technology.
No takes yet. Share an insight, caveat, or question.
Rosman et al. (2018) conducted a systematic review in Patients with cardiovascular implantable electronic devices (n=29). Device-measured physical activity (D-PA) was evaluated on Acute heart failure decompensation, hospitalization, and mortality. Device-measured physical activity combined with other parameters demonstrated modest-to-good sensitivity in predicting acute heart failure decompensation, hospitalization, and mortality in 7 studies.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: