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Increasing Physical Activity After ICD Implantation May Cut Deaths

Risk for mortality reduced with increased physical activity, regardless of participation in cardiac rehabilitation

WEDNESDAY, July 21, 2021 (HealthDay News) — For Medicare beneficiaries with implantable cardioverter defibrillators (ICDs), physical activity (PA) is associated with a reduction in all-cause mortality, according to a study published online July 21 in Circulation: Cardiovascular Quality and Outcomes.

Brett D. Atwater, M.D., from the Inova Heart and Vascular institute in Fairfax, Virginia, and colleagues conducted a retrospective observational study involving 41,731 Medicare beneficiaries with ICD implantation to examine the association of ICD-measured PA with outcomes. Two additional analyses were conducted matching cardiac rehabilitation (CR) participants and nonparticipants using propensity scores to examine whether CR participation altered the effect of PA on outcomes.

Of the Medicare beneficiaries, 3 percent participated in CR. The researchers found increased ICD-detected PA to be associated with improved survival. The mean PA change was +9.7 minutes/day for CR participants compared with −1.0 minute/day for CR nonparticipants. CR participants had significantly lower one- to three-year mortality after matching for demographics, comorbidities, and baseline PA (hazard ratio, 0.76; 95 percent confidence interval, 0.69 to 0.85; P = 0.03). After additional matching for the ICD-measured changes in PA during CR, no differences were seen in mortality with and without CR (hazard ratio, 1.00; 95 percent confidence interval, 0.82 to 1.21; P = 0.87). In both groups, each 10 minutes of increased daily PA were associated with a 1.1 percent reduction in all-cause mortality.

“Our study examined whether physical activity outside of a formal cardiac rehabilitation program could yield similar benefits, and we found it did,” Atwater said in a statement. “This suggests that additional options like home-based cardiac rehabilitation might help more patients realize the health benefits of increased physical activity.”

Several authors disclosed financial ties to the biopharmaceutical and medical device industries; an Abbott Medical-Duke Health Strategic Alliance Research Grant funded the study.

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