Ambrosetti Marco, Sarzi Braga Simona, Giada Franco, Pedretti Roberto F E
Cardiovascular Rehabilitation Unit, Le Terrazze Clinic.
Monaldi Arch Chest Dis. 2017 Nov 30;87(3):791. doi: 10.4081/monaldi.2017.791.
Cardiac resynchronization therapy (CRT) is a therapeutic option of increasing importance for chronic heart failure (CHF) and criteria for implantation now concern a large amount of patient populations. As a consequence, subjects with ongoing CRT (or immediately after CRT implantation) are more often referred to Cardiac Rehabilitation (CR) programmes, and it has been recently estimated that about one third of CHF patients attending CR in Italy currently have this kind of device. The presence of CRT represents a modulating factor for exercise prescription and monitoring, since CRT patients may be considered per se as a target group for CR. Exercise therapy (ET) increases benefits from CRT on functional capacity, and recent evidence suggests an adjuvant role of ET in improving cardiovascular prognosis also. Both aerobic endurance and resistance training activities may involve CHF patients with CRT, while the potential role of aerobic interval training needs more studies and evidence. Prescription of an ET program should be associated with information regarding device programming and possible limiting factors associated with pacing therapy, tailoring of the basic principles of ET (in terms of type of exercise, intensity and program duration) in this patient group is mandatory.
心脏再同步治疗（CRT）是一种对慢性心力衰竭（CHF）越来越重要的治疗选择，目前的植入标准涉及大量患者群体。因此，正在接受CRT治疗（或CRT植入后不久）的患者更常被转诊至心脏康复（CR）项目，最近估计，在意大利参加CR的CHF患者中，约有三分之一目前使用这种装置。CRT的存在是运动处方和监测的一个调节因素，因为CRT患者本身可被视为CR的目标群体。运动疗法（ET）可增加CRT对功能能力的益处，最近的证据还表明ET在改善心血管预后方面具有辅助作用。有氧耐力训练和抗阻训练活动都可能适用于接受CRT治疗的CHF患者，而有氧间歇训练的潜在作用需要更多的研究和证据。ET计划的处方应与有关设备程控以及与起搏治疗相关的可能限制因素的信息相结合，针对该患者群体调整ET的基本原则（在运动类型、强度和计划持续时间方面）是必不可少的。
