Sommers Thomas, Yaeger Amaryah, Lin David, Marchlinski Francis, Nazarian Saman
Department of Medicine, Massachusetts General Hospital, Harvard Medical School, 55 Fruit St, Gray 730, Boston, MA, 02114, USA.
Section of Cardiac Electrophysiology, Cardiovascular Medicine Division, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.
J Interv Card Electrophysiol. 2023 Nov;66(8):1919-1924. doi: 10.1007/s10840-023-01524-w. Epub 2023 Mar 15.
With modern implantable cardioverter-defibrillators (ICDs), biometric measures including physical activity have become readily available to physicians. However, despite the increased availability, applications of these data to the clinical setting remain poorly studied. We sought to investigate whether changes in physical activity occur preceding and following cardiac events in patients with ICDs.
We reviewed the electronic medical records of patients with ICDs implanted for any indication in 2018 and 2019 in the University of Pennsylvania health system. Patients with ICDs that reported physical activity were included in the study only if they experienced major adverse cardiac event(s) (MACE) that were preceded by at least 6 months without MACE after device implantation.
Seventy-four of the 827 charts reviewed met inclusion criteria. Baseline activity levels from 6 to 2 months prior to MACE were 2.18-2.21 h/day. In the month prior to MACE, average activity decreased significantly to 2.09 h/day, and subsequently decreased again during the calendar month in which MACE occurred to 1.96 h/day. The lowest average monthly activity levels occurred in the month after MACE, with incremental but non-significant recovery occurring over the subsequent 2 months.
In a cohort of ICD recipients, a significant decrease in physical activity was observed in the month preceding MACE. To our knowledge, this is the first study that observes time-dependent changes in activity in relation to MACE in a generalizable cohort of ICD recipients. ICD activity monitoring in patients at high risk for MACE may enhance patient care.
借助现代植入式心脏复律除颤器（ICD），包括身体活动在内的生物特征测量数据已 readily 可供医生获取。然而，尽管这些数据的可获取性有所提高，但在临床环境中对这些数据的应用仍研究不足。我们试图调查植入 ICD 的患者在心脏事件前后身体活动是否发生变化。
我们回顾了 2018 年和 2019 年在宾夕法尼亚大学医疗系统因任何适应症植入 ICD 的患者的电子病历。只有在植入设备后至少 6 个月无重大不良心脏事件（MACE），之后又经历了 MACE 的报告有身体活动的 ICD 患者才被纳入研究。
在审查的 827 份病历中，有 74 份符合纳入标准。MACE 前 6 至 2 个月的基线活动水平为每天 2.18 - 2.21 小时。在 MACE 前一个月，平均活动量显著降至每天 2.09 小时，随后在发生 MACE 的日历月中再次降至每天 1.96 小时。最低的平均每月活动水平出现在 MACE 后的月份，在随后的 2 个月中虽有增加但不显著的恢复。
在一组 ICD 接受者中，观察到在 MACE 前一个月身体活动显著减少。据我们所知，这是第一项在可推广的 ICD 接受者队列中观察与 MACE 相关的活动随时间变化的研究。对 MACE 高危患者进行 ICD 活动监测可能会改善患者护理。
