Physical Activity Measured by Implanted Devices Predicts Atrial Arrhythmias and Patient Outcome: Results of IMPLANTED (Italian Multicentre Observational Registry on Patients With Implantable Devices Remotely Monitored)

Figure 1. Two examples of calculation of baseline daily physical activity (PA). Baseline daily PA was calculated as the mean daily activity (in h/d) recorded in the period from 30 to 60 days after device implantation (activity window). A, Patient enrolled in the Boston Scientific Latitude Patient Management System (Boston Scientific, St Paul, MN). The mean daily PA recorded during the activity window was 1.2 h/d (lower‐activity patient). B, Patients enrolled in the Medtronic CareLink Network (Medtronic Inc, Minneapolis, MN). The mean daily PA recorded during the activity window was 4.8 h/d (higher‐activity patient).

Figure 2. Study flow with derivation of the study population. AF indicates atrial fibrillation; AHRE, atrial high‐rate episode; ICD, implantable cardioverter defibrillator; IMPLANTED, Italian Multicentre Observational Registry on Patients With Implantable Devices Remotely Monitored.

Figure 3. Forest plot showing the risk of AHREs lasting ≥6 minutes in the whole study population (n=770) by quintiles of daily physical activity after multivariable analysis. AHRE indicates atrial high‐rate episode; CI, confidence interval; HR, hazard ratio.

Figure 4. Kaplan‐Meier estimates of the cumulative time free from first atrial high‐rate episodes (AHREs) detected by the device, and from clinical events in the low and high physical activity propensity score–matched groups (n=446). A, First AHRE lasting ≥6 minutes. B, First AHRE lasting ≥6 hours. C, First AHRE lasting ≥48 hours. D, All‐cause death or heart failure (HF) hospitalization. E, All‐cause death. F, HF hospitalization. Events are counted after closure of the activity window used to determine baseline physical activity level.