Telecardiology Center, National Institute of Cardiology, Warsaw, Poland.
Department of Coronary Disease and Rehabilitation, National Institute of Cardiology, Warsaw, Poland.
Ann Noninvasive Electrocardiol. 2021 Nov;26(6):e12887. doi: 10.1111/anec.12887. Epub 2021 Sep 9.
Exercise training in heart failure (HF) patients should be monitored to ensure patients' safety. Electrocardiographic (ECG) telemonitoring was used to assess the safety of hybrid comprehensive telerehabilitation (HCTR).
Analysis of ECG recorded during HCTR in HF patients.
The TELEREH-HF multicenter, randomized, controlled trial enrolled 850 HF patients with New York Heart Association class I-III and left ventricular ejection fraction of ≤40%. This subanalysis focuses on 386 patients (aged 62 ± 11 years, LVEF 31 ± 7%) randomized to HCTR. HCTR was telemonitored with a device allowing to record 16-s fragments of ECG and to transmit the data via mobile phone network to the monitoring center. ResultsIn 386 patients, 16,622 HCTR sessions were recorded and 66,488 ECGs fragments were evaluated. Sinus rhythm was present in 320 (83%) and permanent atrial fibrillation (AF) in 66 (17%) patients, respectively. The most common arrhythmias were ventricular and atrial premature beats, recorded in 76.4% and 27.7% of the patients, respectively. Non-sustained ventricular tachycardia (21 episodes in 8 patients) and paroxysmal AF episodes (6 in 4 patients) were rare. None of the analyzed demographic and clinical characteristics was predictive for onset of the new arrhythmias on exercise.
Telerehabilitation in HF patients was safe without the evidence for symptomatic arrhythmias requiring discontinuation of telerehabilitation. Only one mildly symptomatic paroxysmal AF episode led to the short-term suspension of the training program. The most common arrhythmias were atrial and ventricular premature beats. These arrhythmias did not result in any changes in rehabilitation and therapy regimens.
心力衰竭（HF）患者的运动训练应进行监测以确保患者的安全。心电图（ECG）远程监测用于评估混合综合远程康复（HCTR）的安全性。
分析 HF 患者 HCTR 期间记录的 ECG。
TELEREH-HF 多中心、随机、对照试验纳入了 850 例纽约心脏协会（NYHA）心功能分级 I-III 级和左心室射血分数（LVEF）≤40%的 HF 患者。该亚分析重点关注随机分配至 HCTR 的 386 例患者（年龄 62±11 岁，LVEF 31±7%）。HCTR 通过允许记录 16-s ECG 片段并通过移动电话网络将数据传输到监测中心的设备进行远程监测。结果：在 386 例患者中，记录了 16622 次 HCTR 治疗和 66488 个 ECG 片段。窦性节律分别存在于 320（83%）和 66（17%）例患者中，持续性心房颤动（AF）分别存在于 320（83%）和 66（17%）例患者中。最常见的心律失常是室性和房性期前收缩，分别在 76.4%和 27.7%的患者中记录到。非持续性室性心动过速（8 例患者中有 21 个发作）和阵发性 AF 发作（4 例患者中有 6 个发作）很少见。分析的人口统计学和临床特征均不能预测运动时新发心律失常的发生。
HF 患者的远程康复是安全的，没有证据表明需要停止远程康复的症状性心律失常。仅有 1 例轻度症状性阵发性 AF 发作导致短期暂停训练计划。最常见的心律失常是房性和室性期前收缩。这些心律失常并未导致康复和治疗方案发生任何改变。
