Even 10 Minutes of Daily Exercise Beneficial After ICD Impla
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Small increases in daily physical activity are associated with a boost in 1-year survival in patients with heart failure and coronary disease who received an implantable cardioverter defibrillator (ICD), new research suggests.

Increased physical activity (PA) through cardiac rehabilitation (CR) improves outcomes in patients with heart failure and coronary disease, but CR referral remains infrequent. Implantable cardioverter-defibrillators (ICDs) can provide daily PA measurements to patients that may motivate them to increase PA, but it remains unclear if increased ICD measured PA is associated with improved outcomes with and without CR.

This is a retrospective observational study of 41 731 Medicare beneficiaries with ICD implantation, researchers linked daily ICD PA measurements and Medicare claims data to determine if increased PA is associated with a reduction in the likelihood of death or heart failure hospitalization. To determine if CR participation altered the effect of PA on outcomes, we performed two additional analyses matching CR participants and nonparticipants using propensity scores. The first match included demographics, comorbidities, and baseline PA measurements. The second match also included the change in PA measured during CR or the same time frame after ICD implant among nonparticipants.

Results:
-- The mean age was 75 (SD, 10) years, 30 182 beneficiaries (72.3%) were male, and 1324 (3%) participated in CR.

-- Increased ICD detected PA was associated with improved survival. CR participants had a mean PA change of +9.7 (SD, 57.8) min/d, whereas nonparticipants had a mean change of ?1.0 (SD, 59.7) min/d.

-- After matching for demographics, comorbidities and baseline PA, CR participants had significantly lower 1- to 3-year mortality (hazard ratio, 0.76).

-- After additionally matching for the ICD measured change in PA during CR there were no differences in mortality with and without CR.

-- Every 10 minutes of increased daily PA was associated with a 1.1% reduction in all-cause mortality in both groups.

Conclusively, among Medicare beneficiaries with ICDs, small increases in PA were associated with significant reductions in all-cause mortality.

Source: https://www.ahajournals.org/doi/10.1161/CIRCOUTCOMES.120.007580
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