Article

Patient activity (PA) has been demonstrated to predict all-cause
mortality. However, the association between PA and cardiac death is unclear. Aims
The aims of this study were to determine whether PA can predict cardiac death and
what is the cut-off of PA to discriminate cardiac death, as well as the mechanism
underlying the relationship between PA and survival in patients with home monitoring. Methods: This study retrospectively analysed clinical and implantable
cardioverter-defibrillator/cardiac resynchronization therapy defibrillator device
data in 845 patients. Data regarding PA and PP variability during the first 30-60
days of home monitoring were collected, and mean values were calculated. The
primary endpoint was cardiac death, and the secondary endpoint was all-cause
mortality. Results The mean PA percentage was 11 +/- 5.8%. Based on receiver
operating characteristic curve analysis, we determined that a PA cut-off value of
7.84% (113 min) can predict cardiac death. During a mean follow-up period of 31.1
+/- 12.9 months (ranging from three to 60 months), PA </= 7.84% was associated
with increased risks of cardiac death in an unadjusted analysis; after adjusting
in a multivariate Cox model, the relationship remained significant between
PA</=7.84% and cardiac death (hazard ratio = 3.644, 95% confidence interval =
2.424-5.477, p < 0.001). Moreover, a significant correlation was observed between
PA and PP variability ( r = 0.601, p < 0.001). Conclusions :
A baseline PA </=
7.84% was associated with a higher risk of cardiac death in patients who have
survived more than three months after implantable
cardioverter-defibrillator/cardiac resynchronization therapy defibrillator
implantation. PA had a sizable effect on heart rate variability, reflecting autonomic function.

Langue : ANGLAIS