Patient Activity and Survival Following Implantable Cardioverter‐Defibrillator Implantation: The ALTITUDE Activity Study
Background Physical activity data are collected automatically by implantable cardioverter‐defibrillators (ICDs). Though these data potentially provide a quantifiable and easily accessible measure of functional status, its relationship with survival has not been well studied. Methods and Results Pati...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2015-05-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://doi.org/10.1161/JAHA.115.001775 |
| _version_ | 1798000380135604224 |
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| author | Daniel B. Kramer Susan L. Mitchell Joao Monteiro Paul W. Jones Sharon‐Lise Normand David L. Hayes Matthew R. Reynolds |
| author_facet | Daniel B. Kramer Susan L. Mitchell Joao Monteiro Paul W. Jones Sharon‐Lise Normand David L. Hayes Matthew R. Reynolds |
| author_sort | Daniel B. Kramer |
| collection | DOAJ |
| description | Background Physical activity data are collected automatically by implantable cardioverter‐defibrillators (ICDs). Though these data potentially provide a quantifiable and easily accessible measure of functional status, its relationship with survival has not been well studied. Methods and Results Patients enrolled in the Boston Scientific LATITUDE remote monitoring system from 2008 to 2012 with ICDs were eligible. Remote monitoring data were used to calculate mean daily activity at baseline (30 to 60 days after implantation), and longitudinally. Cox regression was used to examine the association between survival and increments of 30 minutes/day in both (1) mean baseline activity and (2) time‐varying activity, with both adjusted for demographic and device characteristics. A total of 98 437 patients were followed for a median of 2.2 years (mean age of 67.7±13.1 years; 71.7% male). Mean baseline daily activity was 107.5±66.2 minutes/day. The proportion of patients surviving after 4 years was significantly higher among those in the most versus least active quintile of mean baseline activity (90.5% vs. 50.0%; log‐rank P value, <0.001). Lower mean baseline activity (i.e., incremental difference of 30‐minutes/day) was independently associated with a higher risk of death (adjusted hazard ratio [AHR], 1.44; 95% confidence interval [CI], 1.427 to 1.462). Time‐varying activity was similarly associated with a higher risk of death (AHR, 1.48; 95% CI, 1.451 to 1.508), indicating that a patient having 30 minutes per day less activity in a given month has a 48% increased hazard for death when compared to a similar patient in the same month. Conclusions Patient activity measured by ICDs strongly correlates with survival following ICD implantation. |
| first_indexed | 2024-04-11T11:19:20Z |
| format | Article |
| id | doaj.art-5adb9edf31e74b2b9d6b10fc1207be9e |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2024-04-11T11:19:20Z |
| publishDate | 2015-05-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-5adb9edf31e74b2b9d6b10fc1207be9e2022-12-22T04:27:06ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802015-05-0145n/an/a10.1161/JAHA.115.001775Patient Activity and Survival Following Implantable Cardioverter‐Defibrillator Implantation: The ALTITUDE Activity StudyDaniel B. Kramer0Susan L. Mitchell1Joao Monteiro2Paul W. Jones3Sharon‐Lise Normand4David L. Hayes5Matthew R. Reynolds6Beth Israel Deaconess Medical Center Boston MABeth Israel Deaconess Medical Center Boston MANorth American Science Associates, Inc Minneapolis MNBoston Scientific St Paul MNHarvard Medical School Boston MAMayo Clinic Rochester MNLahey Clinic Burlington MABackground Physical activity data are collected automatically by implantable cardioverter‐defibrillators (ICDs). Though these data potentially provide a quantifiable and easily accessible measure of functional status, its relationship with survival has not been well studied. Methods and Results Patients enrolled in the Boston Scientific LATITUDE remote monitoring system from 2008 to 2012 with ICDs were eligible. Remote monitoring data were used to calculate mean daily activity at baseline (30 to 60 days after implantation), and longitudinally. Cox regression was used to examine the association between survival and increments of 30 minutes/day in both (1) mean baseline activity and (2) time‐varying activity, with both adjusted for demographic and device characteristics. A total of 98 437 patients were followed for a median of 2.2 years (mean age of 67.7±13.1 years; 71.7% male). Mean baseline daily activity was 107.5±66.2 minutes/day. The proportion of patients surviving after 4 years was significantly higher among those in the most versus least active quintile of mean baseline activity (90.5% vs. 50.0%; log‐rank P value, <0.001). Lower mean baseline activity (i.e., incremental difference of 30‐minutes/day) was independently associated with a higher risk of death (adjusted hazard ratio [AHR], 1.44; 95% confidence interval [CI], 1.427 to 1.462). Time‐varying activity was similarly associated with a higher risk of death (AHR, 1.48; 95% CI, 1.451 to 1.508), indicating that a patient having 30 minutes per day less activity in a given month has a 48% increased hazard for death when compared to a similar patient in the same month. Conclusions Patient activity measured by ICDs strongly correlates with survival following ICD implantation.https://doi.org/10.1161/JAHA.115.001775deathimplantable cardioverter‐defibrillatorssudden |
| spellingShingle | Daniel B. Kramer Susan L. Mitchell Joao Monteiro Paul W. Jones Sharon‐Lise Normand David L. Hayes Matthew R. Reynolds Patient Activity and Survival Following Implantable Cardioverter‐Defibrillator Implantation: The ALTITUDE Activity Study Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease death implantable cardioverter‐defibrillators sudden |
| title | Patient Activity and Survival Following Implantable Cardioverter‐Defibrillator Implantation: The ALTITUDE Activity Study |
| title_full | Patient Activity and Survival Following Implantable Cardioverter‐Defibrillator Implantation: The ALTITUDE Activity Study |
| title_fullStr | Patient Activity and Survival Following Implantable Cardioverter‐Defibrillator Implantation: The ALTITUDE Activity Study |
| title_full_unstemmed | Patient Activity and Survival Following Implantable Cardioverter‐Defibrillator Implantation: The ALTITUDE Activity Study |
| title_short | Patient Activity and Survival Following Implantable Cardioverter‐Defibrillator Implantation: The ALTITUDE Activity Study |
| title_sort | patient activity and survival following implantable cardioverter defibrillator implantation the altitude activity study |
| topic | death implantable cardioverter‐defibrillators sudden |
| url | https://doi.org/10.1161/JAHA.115.001775 |
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