Kim Yeon Mi, Kim Bo Ryun, Pyun Sung Bom, Jung Jae Seung, Kim Hee Jung, Son Ho Sung
Department of Physical Medicine and Rehabilitation, Korea University Anam Hospital, Seoul 02841, Republic of Korea.
Department of Thoracic and Cardiovascular Surgery, Korea University Anam Hospital, Seoul 02841, Republic of Korea.
J Clin Med. 2025 Jul 10;14(14):4887. doi: 10.3390/jcm14144887.
: We aimed to evaluate the safety and feasibility of a remote electrocardiogram (ECG) monitoring-based cardiac rehabilitation (CR) program during an early postoperative period in patients who underwent cardiac surgery. : Five days after cardiac surgery, patients were referred to a CR department and participated in a low-intensity inpatient CR program while wearing an ECG monitoring device. Prior to discharge, the patients underwent a cardiopulmonary exercise test (CPET) and squat endurance test to determine the suitable intensity and target heart rate (HR) for home-based CR (HBCR). During 2 weeks of the HBCR period after discharge, patients participated in aerobic and resistance exercises. Electrocardiogram data were transmitted to a cloud, where researchers closely monitored them through a website and provided feedback to the patients via telephone calls. Grip strength (GS), 6 min walk distance (6 MWD), EuroQol-5 dimension (EQ-5D), short-form 36-item health survey (SF-36), and Korean Activity Scale/Index (KASI) were measured at three different time points: 5 d post-surgery (T1), pre-discharge (T2), and 2 weeks after discharge (T3). Squat endurance tests and CPET were performed only at T2 and T3. : Sixteen patients completed the study, seven (44%) of whom underwent coronary artery bypass graft surgery (CABG). During the study period between T2 and T3, peak VO improved from 12.39 ± 0.57 to 17.93 ± 1.25 mL/kg/min ( < 0.01). The squat endurance test improved from 16.69 ± 2.31 to 21.81 ± 2.31 ( < 0.01). In a comparison of values of time points between T1 and T3, the GS improved from 28.30 ± 1.66 to 30.40 ± 1.70 kg ( = 0.02) and 6 MWD increased from 249.33 ± 20.92 to 387.02 ± 22.77 m ( < 0.01). The EQ-5D and SF-36 improved from 0.59 ± 0.03 to 0.82 ± 0.03 ( < 0.01) and from 83.99 ± 3.40 to 122.82 ± 6.06 ( < 0.01), and KASI improved from 5.44 ± 0.58 to 26.11 ± 2.70 ( < 0.01). In a subgroup analysis, the CABG group demonstrated a greater increase in 6 MWD (102.29 m, < 0.01) than the non-CABG group. At the end of the study, 75% of the patients expressed satisfaction with the early CR program guided by remote ECG monitoring. : Our findings suggest that early remote ECG monitoring-based CR programs are safe and feasible for patients who have undergone cardiac surgery. Additionally, the program improved aerobic capacity, functional status, and quality of life.
我们旨在评估基于远程心电图（ECG）监测的心脏康复（CR）计划在心脏手术后早期患者中的安全性和可行性。心脏手术后5天，患者被转至CR科室，并在佩戴ECG监测设备的同时参加低强度住院CR计划。出院前，患者接受心肺运动试验（CPET）和深蹲耐力试验，以确定居家心脏康复（HBCR）的合适强度和目标心率（HR）。在出院后的2周HBCR期间，患者参加有氧运动和抗阻运动。心电图数据传输至云端，研究人员通过网站密切监测，并通过电话向患者提供反馈。在三个不同时间点测量握力（GS）、6分钟步行距离（6MWD）、欧洲五维健康量表（EQ-5D）、简明健康调查问卷（SF-36）和韩国活动量表/指数（KASI）：术后5天（T1）、出院前（T2）和出院后2周（T3）。仅在T2和T3进行深蹲耐力试验和CPET。16名患者完成了研究，其中7名（44%）接受了冠状动脉旁路移植术（CABG）。在T2至T3的研究期间，峰值摄氧量从12.39±0.57提高至17.93±1.25mL/kg/min（P<0.01）。深蹲耐力试验从16.69±2.31提高至21.81±2.31（P<0.01）。在比较T1和T3时间点的值时，GS从28.30±1.66提高至30.40±1.70kg（P=0.02），6MWD从249.33±20.92增加至387.02±22.77m（P<0.01）。EQ-5D从0.59±0.03提高至0.82±0.03（P<0.01），SF-36从83.99±3.40提高至122.82±6.06（P<0.01），KASI从5.44±0.58提高至26.11±2.70（P<0.01）。在亚组分析中，CABG组的6MWD增加量（102.29m，P<0.01）大于非CABG组。研究结束时，75%的患者对基于远程ECG监测的早期CR计划表示满意。我们的研究结果表明，基于早期远程ECG监测的CR计划对心脏手术患者是安全可行的。此外，该计划改善了有氧运动能力、功能状态和生活质量。
