Key result
Cardiac resynchronization therapy significantly increased long-term physical activity in heart failure patients, with the Activity Log Index rising from 3.6 at baseline to 11.2 at 104 weeks.
Why the study?
Does cardiac resynchronization therapy improve physical activity as measured by device-based Activity Log Index in patients with moderate to severe heart failure?
Cohort (n=178)
No
Does cardiac resynchronization therapy improve physical activity as measured by device-based Activity Log Index in patients with moderate to severe heart failure?
Absolute Event Rate: 11.2% vs 3.6%
p-value: p=<0.005
Device-based monitoring demonstrates that cardiac resynchronization therapy induces a large and sustained long-term increase in physical activity in patients with advanced heart failure.
Sustained activity gains support device monitoring post-CRT; hypothesis-generating and requires RCTs before practice change.
BACKGROUND: Cardiac resynchronization therapy (CRT) improves functional capacity in heart failure patients. This study aimed to prospectively analyze long-term device-based monitoring of physical activity in patients undergoing CRT. METHODS AND RESULTS: The Activity Log Index (ALI), calculated by CRT devices, represents the percentage of time when acceleration exceeds a threshold and monitors the physical activity. Data from 178 CRT patients (New York Heart Association III 91%, left ventricular ejection fraction 21+/-6%, left ventricular end-diastolic diameter 69+/-9 mm, QRS 159+/-27 ms, sinus rhythm 81%) were retrieved. The ALI increased from a baseline value of 3.6+/-2.0 to 11.2+/-4.6 (p<0.005) 104 weeks after initiation of CRT. A plateau was reached at approximately 12 weeks and thereafter ALI remained stable for up to 2 years. The magnitude of the changes in ALI was similar in patients with different etiologies and underlying rhythms. Despite similar values at baseline, elderly patients (>or=65 years) exhibited significantly lower ALI values than younger patients during the follow-up and at the plateau (9.5+/-4.2 vs 13.3+/-4.8, p<0.001). CONCLUSIONS: Device-based monitoring of physical activity in CRT patients is feasible. CRT resulted in a large and long-term increase in physical activity.
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Kawabata et al. (2007) conducted a cohort in Heart failure with ventricular conduction delay (n=178). Cardiac resynchronization therapy (CRT) vs. Baseline was evaluated on Physical activity measured by Activity Log Index (ALI) (p=<0.005). Cardiac resynchronization therapy significantly increased long-term physical activity in heart failure patients, with the Activity Log Index rising from 3.6 at baseline to 11.2 at 104 weeks.
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