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Adherence to an Aerobic Exercise Intervention after an Implantable Cardioverter Defibrillator (ICD)
Author(s) -
DOUGHERTY CYNTHIA M.,
LUTTRELL MATILDA N.,
BURR ROBERT L.,
KIM MISUN,
HASKELL WILLIAM L.
Publication year - 2016
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/pace.12782
Subject(s) - medicine , implantable cardioverter defibrillator , aerobic exercise , intervention (counseling) , sudden cardiac death , cardiology , physical therapy , nursing
Background Exercise adherence is an important element in achieving important exercise outcomes. The purpose of this study was to describe adherence in a home‐based aerobic exercise program following an implantable cardioverter defibrillator (ICD), determine effects of adherence on peakVO 2 , and outline reasons for nonadherence. Methods and Results A single‐blind randomized control trial of home walking compared to usual care in 160 patients with an ICD for primary or secondary prevention was conducted. This report is on adherence in the exercise arm (N = 84). Home walking exercise consisted of 8 weeks of aerobic conditioning (60 minutes/day, 5 days/week) followed by 16 weeks of aerobic maintenance (150 minutes/week, 30 minutes/session) at 60–80% of heart rate reserve. Adherence was tracked using Polar heart rate (HR) monitors, pedometers, home exercise logs, and telephone follow‐up. Adherence was defined as performing at least 80% of prescribed exercise. For aerobic conditioning, there was a mean frequency of 3.81 walks/week, duration of 1,873 minutes walked, and 17.5% of exercise was in the target HR (THR) zone. For aerobic maintenance, there was a mean frequency of 2.4 walks/week, duration of 1,872 minutes/walked, and 8.7% of exercise was in the THR zone. Those who were 80% adherent achieved a 3.4 mL/kg/min (P = 0.03) improvement in peakVO 2 over those who were <80% adherent. Reasons for nonadherence to exercise ranged from scheduling issues to viral illness and fatigue. Conclusions Adherence to aerobic exercise frequency and duration was high with few dropouts, resulting in higher peakVO 2 . Exercise monitoring equipment encouraged adherence and conferred a sense of safety to exercise.