Department of Prevention and Sports Medicine, Technische Universität München, Connollystr. 32, 80809 Munich, Germany.
Int J Cardiol. 2013 Sep 30;168(2):1127-30. doi: 10.1016/j.ijcard.2012.11.050. Epub 2012 Nov 30.
Data on physical activity assessed by cardiac implantable electronic devices (ICD/CRT) have been used for prognostic implications in heart failure patients, but no study has ever compared these data to validated external accelerometers.
73 ICD/CRT recipients (age 60 ± 20 years, 21% female) received a validated external accelerometer over a period of 7 days. Thereafter, data on physical activity of both ICD/CRT and external accelerometers were retrieved and compared using Spearman's rank correlation coefficient and Bland Altman plots.
Mean total daily activity was 276 ± 85 min (range 72-462) as assessed by the external accelerometers and 237 ± 105 min (28-575) as assessed by the ICD/CRT activity sensors (p<0.001). A strong, significant intra-individual correlation (r>0.7) between the two measurements was observed in a majority (70%) of patients (p<0.05 each). However, a Bland Altman plot revealed a broad variation of total daily activity between both methods (95% limits of agreement -225 to 147 min), resulting in differences in the duration of daily activity up to several hours. In multivariate regression analysis, no influence of age, NYHA functional class, left ventricular ejection fraction, underlying disease or type of device on these differences was observed.
As compared to a validated external accelerometer, daily physical activity assessed by ICD/CRT devices shows strong intra-individual correlations, but differs substantially regarding the absolute amount of daily activity. Thus, using ICD/CRT activity data for more precise clinical or prognostic information without prior validation is of limited value.
通过心脏植入式电子设备（ICD/CRT）评估的身体活动数据已用于心力衰竭患者的预后评估，但尚无研究将这些数据与经过验证的外部加速度计进行比较。
73 名 ICD/CRT 患者（年龄 60±20 岁，21%为女性）佩戴经过验证的外部加速度计 7 天。此后，检索并比较了 ICD/CRT 和外部加速度计的身体活动数据，使用 Spearman 秩相关系数和 Bland-Altman 图进行比较。
外部加速度计评估的平均每日总活动量为 276±85 分钟（范围 72-462），而 ICD/CRT 活动传感器评估的为 237±105 分钟（28-575）（p<0.001）。大多数（70%）患者的两种测量方法之间存在较强的、显著的个体内相关性（r>0.7）（p<0.05 各）。然而，Bland-Altman 图显示两种方法之间的总日常活动量存在广泛差异（95%一致性界限为-225 至 147 分钟），导致每日活动时间的差异可达数小时。多元回归分析显示，年龄、NYHA 功能分级、左心室射血分数、基础疾病或设备类型对这些差异无影响。
与经过验证的外部加速度计相比，ICD/CRT 设备评估的日常身体活动具有较强的个体内相关性，但在日常活动量的绝对值上存在显著差异。因此，在没有事先验证的情况下，使用 ICD/CRT 活动数据来获取更精确的临床或预后信息的价值有限。
