The role of cardiopulmonary exercise testing in the initial evaluation of patients wearing intracardiac devices submitted to cardiac rehabilitation

Cardiopulmonary exercise testing(CPET) can be used to determine the maximum exercise capacity, to identify the factors that cause a limitation of the patient's functional capacity, to evaluate symptoms triggered by physical exercise and to reveal specific complications related to intracardiac devices that might occur during the physical rehabilitation program. The rehabilitation of a patient that is wearing an intracardiac device raises some particular issues besides the ones that we meet in a conventionally treated cardiovascular patient. Several clinical studies have shown that the programming mode of the cardiac pacemakers can have a significant influence on the patients exercise capacity, a crucial element of any physical rehabilitation program. CPET is one of the most accurate and comprehensive methods for the evaluation of the pacemaker-wearing patients, being able to optimize their functional capacity and, therefore, should be recommended in all patients before inclusion in cardiac exercise rehabilitation programs.