Israel C W
Klinik für Innere Medizin - Kardiologie, Diabetologie & Nephrologie, Evangelisches Krankenhaus Bielefeld, Burgsteig 13, 33617, Bielefeld, Deutschland.
Herzschrittmacherther Elektrophysiol. 2012 Jun;23(2):94-106. doi: 10.1007/s00399-012-0183-0.
Sport activity is an important issue in many patients with a pacemaker either because they performed sport activities before pacemaker implantation to reduce the cardiovascular risk or to improve the course of an underlying cardiovascular disease (e.g. coronary artery disease, heart failure) by sports. Compared to patients with an implantable cardioverter defibrillator (ICD) the risks from underlying cardiovascular disease (e.g. ischemia, heart failure), arrhythmia, lead dysfunction or inappropriate therapy are less important or absent. Sport is contraindicated in dyspnea at rest, acute heart failure, new complex arrhythmia, acute myocarditis and acute myocardial infarction, valvular disease with indications for intervention and surgery and comorbidities which prevent physical activity. Patients with underlying cardiovascular disease (including hypertension) should preferably perform types and levels of physical activity that are aerobic (with dynamic exercise) such as running, swimming, cycling instead of sport with high anaerobic demands and high muscular workload. In heart failure, studies demonstrated advantages of isometric sport that increases the amount of muscle, thereby preventing cardiac cachexia. Sport with a risk of blows to the chest or physical contact (e.g. boxing, rugby, martial arts) should be avoided. Implantation, programming and follow-up should respect specific precautions to allow optimal physical activity with a pacemaker including implantation of bipolar leads on the side contralateral to the dominant hand, individual programming of the upper sensor and tracking rate and regular exercise testing.
体育活动对于许多植入起搏器的患者来说是一个重要问题，这是因为他们在植入起搏器之前就进行体育活动，以降低心血管风险，或者通过运动改善潜在心血管疾病（如冠状动脉疾病、心力衰竭）的病程。与植入式心脏复律除颤器（ICD）患者相比，潜在心血管疾病（如缺血、心力衰竭）、心律失常、导线功能障碍或不适当治疗带来的风险不那么重要或不存在。静息时呼吸困难、急性心力衰竭、新发复杂心律失常、急性心肌炎和急性心肌梗死、有干预和手术指征的瓣膜疾病以及妨碍身体活动的合并症患者，运动是禁忌的。患有潜在心血管疾病（包括高血压）的患者最好进行有氧（动态运动）的体育活动类型和强度，如跑步、游泳、骑自行车，而不是高无氧需求和高肌肉负荷的运动。在心力衰竭患者中，研究表明等长运动有好处，它能增加肌肉量，从而预防心脏恶病质。应避免有胸部受打击风险或身体接触的运动（如拳击、橄榄球、武术）。起搏器的植入、程控和随访应遵循特定的预防措施，以实现使用起搏器的最佳身体活动，包括在非优势手一侧植入双极导线、对上传感器和跟踪速率进行个体化程控以及定期进行运动测试。
