Article

Indications for implantable cardioverter defibrillators (ICDs) have
been widened considerably during the last decade due to the well-documented
effect in the heart failure population. Exercise training (ET) has a 1A
recommendation in heart failure. However, data on safety and efficacy of ET in
patients with ICDs is sparse.
ICD shocks are associated with reduced quality of
life and increased mortality. Whether ET may have a beneficial effect in heart
failure patients with an ICD is not well documented. METHODS: This review is
based on a systematic search in the Pub Med database using the terms 'exercise
training', 'implantable cardioverter defibrillator', and 'cardiac
rehabilitation'. RESULTS: Nine studies were identified, comprising 1889 patients.
The average duration of exercise-based cardiac rehabilitation (CR) was 9.6 weeks.
Ten ICD therapies (seven shocks) were reported in the 834 patients with ICD
during ET. Between exercise sessions and during follow up 182 events were
recorded including 166 shocks. Three studies (2 randomized) showed that the
control group representing sedentary patients were more prone to ICD discharge
than patients undergoing CR/ET. In all studies the ICD patients improved their
aerobic fitness following ET. Few studies report data on the effect of ET on
anxiety and depression. CONCLUSION: Based on the current literature, ET in
patients with an ICD seems to be safe and is not associated with increased risk
of shocks. ET improves aerobic capacity in ICD patients, while effects on
anxiety, depression and quality of life are still under debate.

Langue : ANGLAIS