Antiarrhythmic effect of 9-week hybrid comprehensive telerehabilitation and its influence on cardiovascular mortality in long-term follow-up – subanalysis of the TELEREHabilitation in Heart Failure Patients randomized clinical trial
Introduction Cardiac rehabilitation is a component of heart failure (HF) management, but its effect on ventricular arrhythmias is not well understood. We analyzed the antiarrhythmic effect of a 9-week hybrid comprehensive telerehabilitation (HCTR) program and its influence on long-term cardiovascula...
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| Format: | Article |
| Language: | English |
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Termedia Publishing House
2021-05-01
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| Series: | Archives of Medical Science |
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| Online Access: | https://www.archivesofmedicalscience.com/Antiarrhythmic-effect-of-9-week-hybrid-comprehensive-telerehabilitation-and-its-influence,136563,0,2.html |
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| author | Piotr Orzechowski Ryszard Piotrowicz Wojciech Zareba Michael J. Pencina Ilona Kowalik Ewa Komar Grzegorz Opolski Maciej Banach Renata Główczyńska Dominika Szalewska Sławomir Pluta Robert Irzmański Zbigniew Kalarus Ewa Piotrowicz |
| author_facet | Piotr Orzechowski Ryszard Piotrowicz Wojciech Zareba Michael J. Pencina Ilona Kowalik Ewa Komar Grzegorz Opolski Maciej Banach Renata Główczyńska Dominika Szalewska Sławomir Pluta Robert Irzmański Zbigniew Kalarus Ewa Piotrowicz |
| author_sort | Piotr Orzechowski |
| collection | DOAJ |
| description | Introduction
Cardiac rehabilitation is a component of heart failure (HF) management, but its effect on ventricular arrhythmias is not well understood. We analyzed the antiarrhythmic effect of a 9-week hybrid comprehensive telerehabilitation (HCTR) program and its influence on long-term cardiovascular mortality in HF patients taken from the TELEREHabilitation in Heart Failure Patients (TELEREH-HF) trial.
Material and methods
We evaluated the presence of non-sustained ventricular tachycardia (nsVT) and frequent premature ventricular complexes ≥ 10 beats/hour (PVCs ≥ 10) in 24-hour ECG monitoring at baseline and after 9-week HCTR or usual care (UC) of 773 HF patients (NYHA I-III, LVEF ≤ 40%). Functional response for HCTR was assessed by changes – delta (Δ) – in peak oxygen consumption (pVO2) as a result of comparing pVO2 from the beginning and the end of the program.
Results
Among 143 patients with nsVT, arrhythmia subsided in 30.8% after HCTR. Similarly, among 165 patients randomized to UC who had nsVT 34.5% did not show it after 9 weeks (p = 0.481). There was no significant difference in the decrease in PVC ≥ 10 over 9 weeks between randomization arms (14.9% vs. 17.8%, respectively p = 0.410). Functional response for HCTR in ΔpVO2 > 2.0 ml/kg/min did not affect occurrence of arrhythmias. Multivariable analysis did not identify HCTR as an independent factor determining improvement of nsVT or PVCs ≥ 10. However, only in the HCTR group, the achievement of the antiarrhythmic effect significantly reduced the cardiovascular mortality in 2-year follow-up (p < 0.001).
Conclusions
Significant improvement in physical capacity after 9 weeks of HCTR did not correlate with the antiarrhythmic effect in terms of incidence of nsVT or PVCs ≥ 10. An antiarrhythmic effect after the 9-week HCTR affected long-term cardiovascular mortality in HF patients. |
| first_indexed | 2024-04-11T10:42:25Z |
| format | Article |
| id | doaj.art-b4722aa5ad864e779d3903e107aa232e |
| institution | Directory Open Access Journal |
| issn | 1734-1922 1896-9151 |
| language | English |
| last_indexed | 2024-04-11T10:42:25Z |
| publishDate | 2021-05-01 |
| publisher | Termedia Publishing House |
| record_format | Article |
| series | Archives of Medical Science |
| spelling | doaj.art-b4722aa5ad864e779d3903e107aa232e2022-12-22T04:29:08ZengTermedia Publishing HouseArchives of Medical Science1734-19221896-91512021-05-0118229330610.5114/aoms/136563136563Antiarrhythmic effect of 9-week hybrid comprehensive telerehabilitation and its influence on cardiovascular mortality in long-term follow-up – subanalysis of the TELEREHabilitation in Heart Failure Patients randomized clinical trialPiotr Orzechowski0Ryszard Piotrowicz1Wojciech Zareba2Michael J. Pencina3Ilona Kowalik4Ewa Komar5Grzegorz Opolski6Maciej Banach7Renata Główczyńska8Dominika Szalewska9Sławomir Pluta10Robert Irzmański11Zbigniew Kalarus12Ewa Piotrowicz13Telecardiology Center, National Institute of Cardiology, Warsaw, PolandNational Institute of Cardiology, Warsaw, PolandDepartment of Medicine, University of Rochester Medical Center, Rochester, United StatesDepartment of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, United StatesNational Institute of Cardiology, Warsaw, PolandMilitary Institute of Medicine, Warsaw, Poland1st Chair Department of Cardiology, Medical University of Warsaw, Warsaw, PolandDepartment of Hypertension, Medical University of Łodz, Łodz, Poland1st Chair Department of Cardiology, Medical University of Warsaw, Warsaw, PolandChair and Clinic of Rehabilitation Medicine, Faculty of Health Sciences, Medical Universiy of Gdańsk, Gdańsk, PolandSilesian Center for Heart Diseases, Zabrze, PolandDepartment of Internal Medicine and Cardiac Rehablitation, Medical University of Łodz, Łodz, PolandDepartment of Cardiology, Congenital Heart Disease and Electrotherapy, Division of Medical Sciences in Zabrze, Medical University of Silesa, Katowice, PolandTelecardiology Center, National Institute of Cardiology, Warsaw, PolandIntroduction Cardiac rehabilitation is a component of heart failure (HF) management, but its effect on ventricular arrhythmias is not well understood. We analyzed the antiarrhythmic effect of a 9-week hybrid comprehensive telerehabilitation (HCTR) program and its influence on long-term cardiovascular mortality in HF patients taken from the TELEREHabilitation in Heart Failure Patients (TELEREH-HF) trial. Material and methods We evaluated the presence of non-sustained ventricular tachycardia (nsVT) and frequent premature ventricular complexes ≥ 10 beats/hour (PVCs ≥ 10) in 24-hour ECG monitoring at baseline and after 9-week HCTR or usual care (UC) of 773 HF patients (NYHA I-III, LVEF ≤ 40%). Functional response for HCTR was assessed by changes – delta (Δ) – in peak oxygen consumption (pVO2) as a result of comparing pVO2 from the beginning and the end of the program. Results Among 143 patients with nsVT, arrhythmia subsided in 30.8% after HCTR. Similarly, among 165 patients randomized to UC who had nsVT 34.5% did not show it after 9 weeks (p = 0.481). There was no significant difference in the decrease in PVC ≥ 10 over 9 weeks between randomization arms (14.9% vs. 17.8%, respectively p = 0.410). Functional response for HCTR in ΔpVO2 > 2.0 ml/kg/min did not affect occurrence of arrhythmias. Multivariable analysis did not identify HCTR as an independent factor determining improvement of nsVT or PVCs ≥ 10. However, only in the HCTR group, the achievement of the antiarrhythmic effect significantly reduced the cardiovascular mortality in 2-year follow-up (p < 0.001). Conclusions Significant improvement in physical capacity after 9 weeks of HCTR did not correlate with the antiarrhythmic effect in terms of incidence of nsVT or PVCs ≥ 10. An antiarrhythmic effect after the 9-week HCTR affected long-term cardiovascular mortality in HF patients.https://www.archivesofmedicalscience.com/Antiarrhythmic-effect-of-9-week-hybrid-comprehensive-telerehabilitation-and-its-influence,136563,0,2.htmlventricular arrhythmiaheart failuretelerehabilitation |
| spellingShingle | Piotr Orzechowski Ryszard Piotrowicz Wojciech Zareba Michael J. Pencina Ilona Kowalik Ewa Komar Grzegorz Opolski Maciej Banach Renata Główczyńska Dominika Szalewska Sławomir Pluta Robert Irzmański Zbigniew Kalarus Ewa Piotrowicz Antiarrhythmic effect of 9-week hybrid comprehensive telerehabilitation and its influence on cardiovascular mortality in long-term follow-up – subanalysis of the TELEREHabilitation in Heart Failure Patients randomized clinical trial Archives of Medical Science ventricular arrhythmia heart failure telerehabilitation |
| title | Antiarrhythmic effect of 9-week hybrid comprehensive telerehabilitation and its influence on cardiovascular mortality in long-term follow-up – subanalysis of the TELEREHabilitation in Heart Failure Patients randomized clinical trial |
| title_full | Antiarrhythmic effect of 9-week hybrid comprehensive telerehabilitation and its influence on cardiovascular mortality in long-term follow-up – subanalysis of the TELEREHabilitation in Heart Failure Patients randomized clinical trial |
| title_fullStr | Antiarrhythmic effect of 9-week hybrid comprehensive telerehabilitation and its influence on cardiovascular mortality in long-term follow-up – subanalysis of the TELEREHabilitation in Heart Failure Patients randomized clinical trial |
| title_full_unstemmed | Antiarrhythmic effect of 9-week hybrid comprehensive telerehabilitation and its influence on cardiovascular mortality in long-term follow-up – subanalysis of the TELEREHabilitation in Heart Failure Patients randomized clinical trial |
| title_short | Antiarrhythmic effect of 9-week hybrid comprehensive telerehabilitation and its influence on cardiovascular mortality in long-term follow-up – subanalysis of the TELEREHabilitation in Heart Failure Patients randomized clinical trial |
| title_sort | antiarrhythmic effect of 9 week hybrid comprehensive telerehabilitation and its influence on cardiovascular mortality in long term follow up subanalysis of the telerehabilitation in heart failure patients randomized clinical trial |
| topic | ventricular arrhythmia heart failure telerehabilitation |
| url | https://www.archivesofmedicalscience.com/Antiarrhythmic-effect-of-9-week-hybrid-comprehensive-telerehabilitation-and-its-influence,136563,0,2.html |
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