Background--To determine whether daily physical activity (PA), as measured by implanted devices (through accelerometer sensor), was related to the risk of developing atrial arrhythmias during long-term follow-up in a population of heart failure (HF) patients with an implantable cardioverter defibrillator (ICD). Methods and Results--The study population was divided into 2 equally sized groups (PA cutoff point: 3.5 h/d) according to their mean daily PA recorded by the device during the 30- to 60-day period post-ICD implantation. Propensity score matching was used to compare 2 equally sized cohorts with similar characteristics between lower and higher activity patients. The primary end point was time free from the first atrial high-rate episode (AHRE) of duration ≥6 minutes. Secondary end points were: first AHRE ≥6 hours, first AHRE ≥48 hours, and a combined end point of death or HF hospitalization. Data from 770 patients (65±15 years; 66% men; left ventricular ejection fraction 35±12%) remotely monitored for a median of 25 months were analyzed. A PA =3.5 h/d was associated with a 38% relative reduction in the risk of AHRE ≥6 minutes (72-month cumulative survival: 75.0% versus 68.1%; log rank P=0.025), and with a reduction in the risk of AHRE ≥6 hours, AHRE ≥48 hours, and the combined end point of death or HF hospitalization (all P < 0.05). Conclusions--In HF patients with ICD, a low level of daily PA was associated with a higher risk of atrial arrhythmias, regardless of the patients' baseline characteristics. In addition, a lower daily PA predicted death or HF hospitalization.

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) / Palmisano, Pietro; Guerra, Federico; Ammendola, Ernesto; Ziacchi, Matteo; Pisanó, Ennio Carmine Luigi; Dell'Era, Gabriele; Aspromonte, Vittorio; Zaccaria, Maria; Di Ubaldo, Francesco; Capucci, Alessandro; Nigro, Gerardo; Occhetta, Eraldo; Maglia, Giampiero; Ricci, Renato Pietro; Boriani, Giuseppe; Accogli, Michele; Botto, Gian Luca; Bertaglia, Emanuele; Berisso, Massimo Zoni; Nissardi, Vincenzo; Santini, Luca; Soldati, Ezio; Stabile, Giuseppe; Landolina, Maurizio; Padeletti, Luigi. - In: JOURNAL OF THE AMERICAN HEART ASSOCIATION. CARDIOVASCULAR AND CEREBROVASCULAR DISEASE. - ISSN 2047-9980. - 7:5(2018), pp. N/A-N/A. [10.1161/JAHA.117.008146]

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)

Boriani, Giuseppe;
2018

Abstract

Background--To determine whether daily physical activity (PA), as measured by implanted devices (through accelerometer sensor), was related to the risk of developing atrial arrhythmias during long-term follow-up in a population of heart failure (HF) patients with an implantable cardioverter defibrillator (ICD). Methods and Results--The study population was divided into 2 equally sized groups (PA cutoff point: 3.5 h/d) according to their mean daily PA recorded by the device during the 30- to 60-day period post-ICD implantation. Propensity score matching was used to compare 2 equally sized cohorts with similar characteristics between lower and higher activity patients. The primary end point was time free from the first atrial high-rate episode (AHRE) of duration ≥6 minutes. Secondary end points were: first AHRE ≥6 hours, first AHRE ≥48 hours, and a combined end point of death or HF hospitalization. Data from 770 patients (65±15 years; 66% men; left ventricular ejection fraction 35±12%) remotely monitored for a median of 25 months were analyzed. A PA =3.5 h/d was associated with a 38% relative reduction in the risk of AHRE ≥6 minutes (72-month cumulative survival: 75.0% versus 68.1%; log rank P=0.025), and with a reduction in the risk of AHRE ≥6 hours, AHRE ≥48 hours, and the combined end point of death or HF hospitalization (all P < 0.05). Conclusions--In HF patients with ICD, a low level of daily PA was associated with a higher risk of atrial arrhythmias, regardless of the patients' baseline characteristics. In addition, a lower daily PA predicted death or HF hospitalization.
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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) / Palmisano, Pietro; Guerra, Federico; Ammendola, Ernesto; Ziacchi, Matteo; Pisanó, Ennio Carmine Luigi; Dell'Era, Gabriele; Aspromonte, Vittorio; Zaccaria, Maria; Di Ubaldo, Francesco; Capucci, Alessandro; Nigro, Gerardo; Occhetta, Eraldo; Maglia, Giampiero; Ricci, Renato Pietro; Boriani, Giuseppe; Accogli, Michele; Botto, Gian Luca; Bertaglia, Emanuele; Berisso, Massimo Zoni; Nissardi, Vincenzo; Santini, Luca; Soldati, Ezio; Stabile, Giuseppe; Landolina, Maurizio; Padeletti, Luigi. - In: JOURNAL OF THE AMERICAN HEART ASSOCIATION. CARDIOVASCULAR AND CEREBROVASCULAR DISEASE. - ISSN 2047-9980. - 7:5(2018), pp. N/A-N/A. [10.1161/JAHA.117.008146]
Palmisano, Pietro; Guerra, Federico; Ammendola, Ernesto; Ziacchi, Matteo; Pisanó, Ennio Carmine Luigi; Dell'Era, Gabriele; Aspromonte, Vittorio; Zaccaria, Maria; Di Ubaldo, Francesco; Capucci, Alessandro; Nigro, Gerardo; Occhetta, Eraldo; Maglia, Giampiero; Ricci, Renato Pietro; Boriani, Giuseppe; Accogli, Michele; Botto, Gian Luca; Bertaglia, Emanuele; Berisso, Massimo Zoni; Nissardi, Vincenzo; Santini, Luca; Soldati, Ezio; Stabile, Giuseppe; Landolina, Maurizio; Padeletti, Luigi
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11380/1168115
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