Benefits of cardiac rehabilitation in patients with implantable cardioverter-defibrillators: A patient survey

Objectives: To determine whether participation in an outpatient cardiac rehabilitation (OCR) program increases exercise levels and decreases shocks in patients with implantable cardioverter-defibrillators (ICDs). Design: Retrospective comparative survey. Setting: University tertiary-care ICD clinic. Participants: Patients with ICDs and coronary artery disease. Intervention: Participation in OCR (nonrandomized). Main Outcome Measures: Exercise levels and OCR participation were determined through a telephone survey of patients with ICDs. The incidence of shock-treated arrhythmia was determined by review of charts and ICD data storage disks. Results: Of 82 patients (85% men; mean age, 61 +/- 8y). 28 (34%) participated in OCR after receiving an ICD. There was no difference in age, sex, ejection fraction, or length of follow-up between OCR and non-OCR groups. Median intensity of regular exercise was 5.3 metabolic equivalents (METS) for OCR patients versus 3.5 METS for non-OCR patients (P < .02). In follow-up (mean, 48 +/- 3mo), non-OCR patients were more likely to receive any shock, shocks during exercise, or shocks for ventricular arrhythmia during exercise than OCR patients (all P < .05). Non-OCR remained a predictor of shock after adjustment for exercise limitation (P < .05). Conclusions: OCR patients exercised more and had fewer shocks. Physicians and health plans should encourage ICD patients to participate in OCR.