**标题**：COVID-19 大流行对植入式心脏电子设备患者身体活动的影响：一项远程监测研究 **摘要**：研究目的：COVID-19 大流行对植入式心脏电子设备患者身体活动的影响。研究设计和方法：前瞻性观察性研究。研究地点：远程医疗诊所。研究对象：COVID-19 大流行期间在远程医疗诊所接受心脏电子设备监测的患者。研究方法：通过远程监测系统收集患者的身体活动数据。主要结局测量：COVID-19 大流行前后患者身体活动的变化。结果：共纳入 117 例患者，平均年龄为 73.5±10.1 岁，其中男性占 66.7%。COVID-19 大流行期间，患者的身体活动水平显著下降（P<0.001）。与 COVID-19 大流行前相比，COVID-19 大流行期间患者的每周步数减少了 2,172 步（95%CI：-3,233 至-1,109，P<0.001），每周活动时间减少了 24.5 分钟（95%CI：-37.4 至-11.6，P<0.001）。结论：COVID-19 大流行对植入式心脏电子设备患者的身体活动水平产生了负面影响。远程监测系统可以帮助医生及时发现患者身体活动水平的变化，并采取相应的干预措施。
Impact of coronavirus disease (COVID-19) pandemic on physical activity of patients with cardiac implantable electronic devices-A remote monitoring study.
机构信息
Medizinische Klinik und Poliklinik I, Universitätsklinikum Würzburg, Würzburg, Germany.
Institut für Informatik, Martin-Luther-Universität Halle-Wittenberg, Halle, Germany.
出版信息
PLoS One. 2022 Aug 12;17(8):e0269816. doi: 10.1371/journal.pone.0269816. eCollection 2022.
OBJECTIVES
The study aims to investigate the impact of COVID-19 pandemic on physical activity and frequency of implantable cardioverter-defibrillator (ICD) therapies of patients with cardiac implantable electronic devices.
METHODS AND RESULTS
Physical activity, heart rate and ICD-therapies were assessed via routine remote monitoring over two years. We focussed on a 338-day period during COVID-19 pandemic that was divided in 6 time-intervals defined by public health interventions and compared to the previous regular year. Paired nonparametric longitudinal analysis was performed to detect differences between time-intervals. To model effects of age, sex and time we applied a nonparametric ANOVA-type-statistic. 147 patients with cardiac implantable electronic devices were analysed. Longitudinal analysis of physical activity in 2019 and 2020 showed a specific weekly and seasonal pattern. Physical activity was reduced during the pandemic (mean daily physical activity 2019: 12.4% vs. 2020: 11.5%; p<0.0001) with the strongest reductions (fold changes 0.885/0.889, p<0.0001/p<0.0001) during the two lockdown-periods. In older patients (>70 years), physical activity was decreased in every time-interval of the year 2020. In time-intervals of eased restrictions, physical activity of younger patients (≤70 years) was not different compared to 2019. No variation in mean heart rate, arrhythmia-burden and count of ICD-therapies was found.
CONCLUSION
Physical activity shows fluctuations dependent on days of the week and time of the year. During the pandemic, physical activity was reduced in patients with cardiac implantable electronic devices with the strongest reductions during lockdown-periods. Younger patients resumed former levels of physical activity in times of eased restrictions while older patients remained less active. Thus, activation of the elderly population is important to prevent long-term health impairments due to the pandemic.
目的
本研究旨在探讨 COVID-19 大流行对植入式心脏复律除颤器（ICD）患者的身体活动和 ICD 治疗频率的影响。
方法和结果
通过两年的常规远程监测评估身体活动、心率和 ICD 治疗。我们重点关注 COVID-19 大流行期间的 338 天，将其分为 6 个时间段，这些时间段由公共卫生干预措施定义，并与前一年进行比较。采用非参数纵向分析来检测时间段之间的差异。为了模拟年龄、性别和时间的影响，我们应用了一种非参数 ANOVA 型统计量。分析了 147 例植入式心脏电子设备患者。2019 年和 2020 年身体活动的纵向分析显示出特定的每周和季节性模式。大流行期间身体活动减少（2019 年平均日常身体活动：12.4%比 2020 年：11.5%；p<0.0001），在两次封锁期间减少幅度最大（折叠变化 0.885/0.889，p<0.0001/p<0.0001）。在年龄较大的患者（>70 岁）中，2020 年每个时间段的身体活动都减少了。在限制放宽的时间段，年轻患者（≤70 岁）的身体活动与 2019 年无差异。平均心率、心律失常负担和 ICD 治疗次数无变化。
结论
身体活动表现出依赖于一周中的天数和一年中的时间的波动。在大流行期间，植入式心脏复律除颤器患者的身体活动减少，在封锁期间减少幅度最大。在限制放宽期间，年轻患者恢复了以前的身体活动水平，而老年患者的身体活动仍然较少。因此，激活老年人群对于预防因大流行导致的长期健康损害非常重要。
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