de la Uz Caridad M, Burch Ashley E, Gunderson Bruce, Koehler Jodi, Sears Samuel F
The Lillie Frank Abercrombie Section of Pediatric Cardiology Texas Children's Hospital, Baylor College of Medicine, Houston, TX, USA.
Department of Psychology, East Carolina University, Greenville, NC, USA.
Pacing Clin Electrophysiol. 2017 Nov;40(11):1286-1290. doi: 10.1111/pace.13197. Epub 2017 Oct 10.
The daily activity of pediatric patients with implantable cardiac devices provides behavioral evidence of functional outcomes. Modern devices provide continuous accelerometer data that are sensitive to movement, but normative values have not been published for pediatric activity rates. This study provides the first normative accelerometer data on activity rates in a large sample of pediatric cardiac device patients.
Patients were between 3 and 18 years old (N = 1,905) and implanted with a cardiac device from a single device company, and enrolled in remote monitoring.
The median age at implant was 14 years (interquartile range = 12-16); 61.3% were male. Data for 4 weeks were extracted from a company database at 53 weeks postimplant and an average of daily activity was calculated. Daily average activity for all patients was 5.4 hours (standard deviation = 2.0). In a multivariate analysis, increased level of activity was associated with: being male, having a pacemaker versus implantable cardioverter defibrillator (ICD), epicardial device location, rate response turned off, having experienced a shock, and younger age.
These results provide the first baseline data of physical activity in children with implanted cardiac devices and provide a clinical guide to physical activity assessment in this population. Further, our data suggest physical activity in children with implantable cardiac devices may differ based on demographic variables, device type, device location, indication for implantation, and history of ICD shock.
植入心脏装置的儿科患者的日常活动为功能结局提供了行为学证据。现代装置可提供对运动敏感的连续加速度计数据，但尚未公布儿科活动率的标准值。本研究提供了大量儿科心脏装置患者活动率的首个标准加速度计数据。
患者年龄在3至18岁之间（N = 1905），植入了来自单一装置公司的心脏装置，并参与了远程监测。
植入时的中位年龄为14岁（四分位间距 = 12 - 16）；61.3%为男性。在植入后53周从公司数据库中提取4周的数据，并计算每日平均活动量。所有患者的每日平均活动量为5.4小时（标准差 = 2.0）。在多变量分析中，活动水平增加与以下因素相关：男性、植入起搏器而非植入式心律转复除颤器（ICD）、心外膜装置位置、速率应答关闭、经历过电击以及年龄较小。
这些结果提供了植入心脏装置儿童身体活动的首个基线数据，并为该人群的身体活动评估提供了临床指南。此外，我们的数据表明，植入心脏装置儿童的身体活动可能因人口统计学变量、装置类型、装置位置、植入指征以及ICD电击史而有所不同。
