Article

Despite the increasing use of left ventricular assist devices (LVADs)
in terminal heart failure, cardiac rehabilitation protocols have not yet been
documented in larger LVAD patient cohorts. The aim of this study was to
investigate safety and efficacy of exercise training during a rehabilitation
programme after post-operative discharge of LVAD patients. METHODS:
Rehabilitation data obtained between 2010-2012 from 41 LVAD patients (mean age
54.8 +/- 11.6 years; 20% female) were retrospectively analysed. The exercise
protocol consisted of strength exercises for lower limbs, bicycle ergometry,
walking and gymnastics. The numbers of training sessions, their duration and
intensity as well as adverse events were documented. Spiroergometry was performed
at least once and twice in a subgroup of 15 patients (at the beginning and end of
rehabilitation). RESULTS: Rehabilitation started 48 +/- 38 days post LVAD
implantation with an average duration of 32 +/- 6 days. An increase in exercise
capacity was observed. Duration (19 +/- 4 vs 14 +/- 2 min, p < 0.001) and
intensity of bicycle ergometry increased (module number 6.2 +/- 2.8 vs 2.0 +/-
1.9, p < 0.001) as well as muscular strength all muscle groups trained (e.g. 33.6
+/- 15.2 vs 26.6 +/- 11.9 kg at the leg press, p = 0.002). Spiroergometry
revealed an increase of maximal oxygen consumption (14.5 +/- 5.2 vs 11.3 +/- 4.1
ml/min/kg, p = 0.007) in the subgroup that underwent two examinations. In the
whole population the average increase was lower (12.81 +/- 4.35 ml/min/kg). One
training-related adverse event (non-sustained ventricular tachycardia) was
observed. CONCLUSION: Exercise training for LVAD patient as part of a
multidisciplinary rehabilitation programme is effective and safe. This warrants
the broad application of exercise training after LVAD implantation.
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Langue : ANGLAIS