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Rohrer U, Reischl A, Manninger M, Binder RK, Fiedler L, Gruska M, Altenberger J, Dorr A, Steinwender C, Stuehlinger M, Wonisch M, Zirngast B, Zweiker D, Zirlik A, Scherr D. Cardiovascular Rehabilitation With a WCD-Data From the CR3 Study (Cardiac Rehab Retrospective Review). J Cardiopulm Rehabil Prev 2024; 44:115-120. [PMID: 38032261 PMCID: PMC10913858 DOI: 10.1097/hcr.0000000000000832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2023]
Abstract
PURPOSE Patients at risk for sudden cardiac death may temporarily need a wearable cardioverter-defibrillator (WCD). Exercise-based cardiac rehabilitation (CR) has a class I recommendation in patients with cardiac disease. The aim of this study was to evaluate the safety and feasibility of undergoing CR with a WCD. METHODS We performed a retrospective analysis of all patients with a WCD who completed a CR in Austria (2010-2020). RESULTS Patients (n = 55, 60 ± 11 yr, 16% female) with a median baseline left ventricular ejection fraction (LVEF) of 36 (30, 41)% at the start of CR showed a daily WCD wearing duration of 23.4 (22, 24) hr. There were 2848 (8 [1, 26]/patient) automatic alarms and 340 (3 [1, 7]/patient) manual alarms generated. No shocks were delivered by the WCD during the CR period. One patient had recurrent hemodynamically tolerated ventricular tachycardias that were controlled with antiarrhythmic drugs.No severe WCD-associated adverse events occurred during the CR stay of a median 28 (28, 28) d. The fabric garment and the device setting needed to be adjusted in two patients to diminish inappropriate automatic alarms. Left ventricular ejection fraction after CR increased significantly to 42 (30, 44)% ( P < .001). Wearable cardioverter-defibrillator therapy was stopped due to LVEF restitution in 53% of patients. In 36% of patients an implantable cardioverter-defibrillator was implanted, 6% had LVEF improvement after coronary revascularization, one patient received a heart transplantation (2%), two patients discontinued WCD treatment at their own request (4%). CONCLUSION Completing CR is feasible and safe for WCD patients and may contribute positively to the restitution of cardiac function.
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Affiliation(s)
- Ursula Rohrer
- Division of Internal Medicine, Department of Cardiology, Medical University of Graz, Graz, Austria (Drs Rohrer, Manninger, Zweiker, Zirlik, and Scherr and Ms Reischl); Division of Cardiology and Intensive Care, Department of Medicine, Hospital Klinikum Wels-Grieskirchen, Wels, Austria (Dr Binder); Division of Internal Medicine, Cardiology and Nephrology, Department of Medicine, Hospital Wiener Neustadt, Wiener Neustadt, Austria, and Division of Cardiology, Department of Medicine, University Hospital Salzburg, Salzburg, Austria (Dr Fiedler); Department of Science, Innovation and Medical Performance Development of the Austrian Pension Insurance Institution (PVA), Vienna, Austria (Dr Gruska); SKA-Rehabilitation Center Großgmain (PVA), Großgmain, Austria (Dr Altenberger); SKA-Rehabilitation Center St Radegund (PVA), Graz, Austria (Dr Dorr); Division of Cardiology and Intensive Care, Department of Medicine, Kepler University Hospital, Linz, Austria (Dr Steinwender); Division of Cardiology and Angiology, Department of Medicine, University Hospital Innsbruck, Innsbruck, Austria (Dr Stuehlinger); Private Practice for Cardiology and Sports Medicine, Graz, Austria (Dr Wonisch); and Division of Cardiac Surgery, Medical University of Graz, Graz, Austria (Zirngast)
| | - Anja Reischl
- Division of Internal Medicine, Department of Cardiology, Medical University of Graz, Graz, Austria (Drs Rohrer, Manninger, Zweiker, Zirlik, and Scherr and Ms Reischl); Division of Cardiology and Intensive Care, Department of Medicine, Hospital Klinikum Wels-Grieskirchen, Wels, Austria (Dr Binder); Division of Internal Medicine, Cardiology and Nephrology, Department of Medicine, Hospital Wiener Neustadt, Wiener Neustadt, Austria, and Division of Cardiology, Department of Medicine, University Hospital Salzburg, Salzburg, Austria (Dr Fiedler); Department of Science, Innovation and Medical Performance Development of the Austrian Pension Insurance Institution (PVA), Vienna, Austria (Dr Gruska); SKA-Rehabilitation Center Großgmain (PVA), Großgmain, Austria (Dr Altenberger); SKA-Rehabilitation Center St Radegund (PVA), Graz, Austria (Dr Dorr); Division of Cardiology and Intensive Care, Department of Medicine, Kepler University Hospital, Linz, Austria (Dr Steinwender); Division of Cardiology and Angiology, Department of Medicine, University Hospital Innsbruck, Innsbruck, Austria (Dr Stuehlinger); Private Practice for Cardiology and Sports Medicine, Graz, Austria (Dr Wonisch); and Division of Cardiac Surgery, Medical University of Graz, Graz, Austria (Zirngast)
| | - Martin Manninger
- Division of Internal Medicine, Department of Cardiology, Medical University of Graz, Graz, Austria (Drs Rohrer, Manninger, Zweiker, Zirlik, and Scherr and Ms Reischl); Division of Cardiology and Intensive Care, Department of Medicine, Hospital Klinikum Wels-Grieskirchen, Wels, Austria (Dr Binder); Division of Internal Medicine, Cardiology and Nephrology, Department of Medicine, Hospital Wiener Neustadt, Wiener Neustadt, Austria, and Division of Cardiology, Department of Medicine, University Hospital Salzburg, Salzburg, Austria (Dr Fiedler); Department of Science, Innovation and Medical Performance Development of the Austrian Pension Insurance Institution (PVA), Vienna, Austria (Dr Gruska); SKA-Rehabilitation Center Großgmain (PVA), Großgmain, Austria (Dr Altenberger); SKA-Rehabilitation Center St Radegund (PVA), Graz, Austria (Dr Dorr); Division of Cardiology and Intensive Care, Department of Medicine, Kepler University Hospital, Linz, Austria (Dr Steinwender); Division of Cardiology and Angiology, Department of Medicine, University Hospital Innsbruck, Innsbruck, Austria (Dr Stuehlinger); Private Practice for Cardiology and Sports Medicine, Graz, Austria (Dr Wonisch); and Division of Cardiac Surgery, Medical University of Graz, Graz, Austria (Zirngast)
| | - Ronald K. Binder
- Division of Internal Medicine, Department of Cardiology, Medical University of Graz, Graz, Austria (Drs Rohrer, Manninger, Zweiker, Zirlik, and Scherr and Ms Reischl); Division of Cardiology and Intensive Care, Department of Medicine, Hospital Klinikum Wels-Grieskirchen, Wels, Austria (Dr Binder); Division of Internal Medicine, Cardiology and Nephrology, Department of Medicine, Hospital Wiener Neustadt, Wiener Neustadt, Austria, and Division of Cardiology, Department of Medicine, University Hospital Salzburg, Salzburg, Austria (Dr Fiedler); Department of Science, Innovation and Medical Performance Development of the Austrian Pension Insurance Institution (PVA), Vienna, Austria (Dr Gruska); SKA-Rehabilitation Center Großgmain (PVA), Großgmain, Austria (Dr Altenberger); SKA-Rehabilitation Center St Radegund (PVA), Graz, Austria (Dr Dorr); Division of Cardiology and Intensive Care, Department of Medicine, Kepler University Hospital, Linz, Austria (Dr Steinwender); Division of Cardiology and Angiology, Department of Medicine, University Hospital Innsbruck, Innsbruck, Austria (Dr Stuehlinger); Private Practice for Cardiology and Sports Medicine, Graz, Austria (Dr Wonisch); and Division of Cardiac Surgery, Medical University of Graz, Graz, Austria (Zirngast)
| | - Lukas Fiedler
- Division of Internal Medicine, Department of Cardiology, Medical University of Graz, Graz, Austria (Drs Rohrer, Manninger, Zweiker, Zirlik, and Scherr and Ms Reischl); Division of Cardiology and Intensive Care, Department of Medicine, Hospital Klinikum Wels-Grieskirchen, Wels, Austria (Dr Binder); Division of Internal Medicine, Cardiology and Nephrology, Department of Medicine, Hospital Wiener Neustadt, Wiener Neustadt, Austria, and Division of Cardiology, Department of Medicine, University Hospital Salzburg, Salzburg, Austria (Dr Fiedler); Department of Science, Innovation and Medical Performance Development of the Austrian Pension Insurance Institution (PVA), Vienna, Austria (Dr Gruska); SKA-Rehabilitation Center Großgmain (PVA), Großgmain, Austria (Dr Altenberger); SKA-Rehabilitation Center St Radegund (PVA), Graz, Austria (Dr Dorr); Division of Cardiology and Intensive Care, Department of Medicine, Kepler University Hospital, Linz, Austria (Dr Steinwender); Division of Cardiology and Angiology, Department of Medicine, University Hospital Innsbruck, Innsbruck, Austria (Dr Stuehlinger); Private Practice for Cardiology and Sports Medicine, Graz, Austria (Dr Wonisch); and Division of Cardiac Surgery, Medical University of Graz, Graz, Austria (Zirngast)
| | - Michael Gruska
- Division of Internal Medicine, Department of Cardiology, Medical University of Graz, Graz, Austria (Drs Rohrer, Manninger, Zweiker, Zirlik, and Scherr and Ms Reischl); Division of Cardiology and Intensive Care, Department of Medicine, Hospital Klinikum Wels-Grieskirchen, Wels, Austria (Dr Binder); Division of Internal Medicine, Cardiology and Nephrology, Department of Medicine, Hospital Wiener Neustadt, Wiener Neustadt, Austria, and Division of Cardiology, Department of Medicine, University Hospital Salzburg, Salzburg, Austria (Dr Fiedler); Department of Science, Innovation and Medical Performance Development of the Austrian Pension Insurance Institution (PVA), Vienna, Austria (Dr Gruska); SKA-Rehabilitation Center Großgmain (PVA), Großgmain, Austria (Dr Altenberger); SKA-Rehabilitation Center St Radegund (PVA), Graz, Austria (Dr Dorr); Division of Cardiology and Intensive Care, Department of Medicine, Kepler University Hospital, Linz, Austria (Dr Steinwender); Division of Cardiology and Angiology, Department of Medicine, University Hospital Innsbruck, Innsbruck, Austria (Dr Stuehlinger); Private Practice for Cardiology and Sports Medicine, Graz, Austria (Dr Wonisch); and Division of Cardiac Surgery, Medical University of Graz, Graz, Austria (Zirngast)
| | - Johann Altenberger
- Division of Internal Medicine, Department of Cardiology, Medical University of Graz, Graz, Austria (Drs Rohrer, Manninger, Zweiker, Zirlik, and Scherr and Ms Reischl); Division of Cardiology and Intensive Care, Department of Medicine, Hospital Klinikum Wels-Grieskirchen, Wels, Austria (Dr Binder); Division of Internal Medicine, Cardiology and Nephrology, Department of Medicine, Hospital Wiener Neustadt, Wiener Neustadt, Austria, and Division of Cardiology, Department of Medicine, University Hospital Salzburg, Salzburg, Austria (Dr Fiedler); Department of Science, Innovation and Medical Performance Development of the Austrian Pension Insurance Institution (PVA), Vienna, Austria (Dr Gruska); SKA-Rehabilitation Center Großgmain (PVA), Großgmain, Austria (Dr Altenberger); SKA-Rehabilitation Center St Radegund (PVA), Graz, Austria (Dr Dorr); Division of Cardiology and Intensive Care, Department of Medicine, Kepler University Hospital, Linz, Austria (Dr Steinwender); Division of Cardiology and Angiology, Department of Medicine, University Hospital Innsbruck, Innsbruck, Austria (Dr Stuehlinger); Private Practice for Cardiology and Sports Medicine, Graz, Austria (Dr Wonisch); and Division of Cardiac Surgery, Medical University of Graz, Graz, Austria (Zirngast)
| | - Andreas Dorr
- Division of Internal Medicine, Department of Cardiology, Medical University of Graz, Graz, Austria (Drs Rohrer, Manninger, Zweiker, Zirlik, and Scherr and Ms Reischl); Division of Cardiology and Intensive Care, Department of Medicine, Hospital Klinikum Wels-Grieskirchen, Wels, Austria (Dr Binder); Division of Internal Medicine, Cardiology and Nephrology, Department of Medicine, Hospital Wiener Neustadt, Wiener Neustadt, Austria, and Division of Cardiology, Department of Medicine, University Hospital Salzburg, Salzburg, Austria (Dr Fiedler); Department of Science, Innovation and Medical Performance Development of the Austrian Pension Insurance Institution (PVA), Vienna, Austria (Dr Gruska); SKA-Rehabilitation Center Großgmain (PVA), Großgmain, Austria (Dr Altenberger); SKA-Rehabilitation Center St Radegund (PVA), Graz, Austria (Dr Dorr); Division of Cardiology and Intensive Care, Department of Medicine, Kepler University Hospital, Linz, Austria (Dr Steinwender); Division of Cardiology and Angiology, Department of Medicine, University Hospital Innsbruck, Innsbruck, Austria (Dr Stuehlinger); Private Practice for Cardiology and Sports Medicine, Graz, Austria (Dr Wonisch); and Division of Cardiac Surgery, Medical University of Graz, Graz, Austria (Zirngast)
| | - Clemens Steinwender
- Division of Internal Medicine, Department of Cardiology, Medical University of Graz, Graz, Austria (Drs Rohrer, Manninger, Zweiker, Zirlik, and Scherr and Ms Reischl); Division of Cardiology and Intensive Care, Department of Medicine, Hospital Klinikum Wels-Grieskirchen, Wels, Austria (Dr Binder); Division of Internal Medicine, Cardiology and Nephrology, Department of Medicine, Hospital Wiener Neustadt, Wiener Neustadt, Austria, and Division of Cardiology, Department of Medicine, University Hospital Salzburg, Salzburg, Austria (Dr Fiedler); Department of Science, Innovation and Medical Performance Development of the Austrian Pension Insurance Institution (PVA), Vienna, Austria (Dr Gruska); SKA-Rehabilitation Center Großgmain (PVA), Großgmain, Austria (Dr Altenberger); SKA-Rehabilitation Center St Radegund (PVA), Graz, Austria (Dr Dorr); Division of Cardiology and Intensive Care, Department of Medicine, Kepler University Hospital, Linz, Austria (Dr Steinwender); Division of Cardiology and Angiology, Department of Medicine, University Hospital Innsbruck, Innsbruck, Austria (Dr Stuehlinger); Private Practice for Cardiology and Sports Medicine, Graz, Austria (Dr Wonisch); and Division of Cardiac Surgery, Medical University of Graz, Graz, Austria (Zirngast)
| | - Markus Stuehlinger
- Division of Internal Medicine, Department of Cardiology, Medical University of Graz, Graz, Austria (Drs Rohrer, Manninger, Zweiker, Zirlik, and Scherr and Ms Reischl); Division of Cardiology and Intensive Care, Department of Medicine, Hospital Klinikum Wels-Grieskirchen, Wels, Austria (Dr Binder); Division of Internal Medicine, Cardiology and Nephrology, Department of Medicine, Hospital Wiener Neustadt, Wiener Neustadt, Austria, and Division of Cardiology, Department of Medicine, University Hospital Salzburg, Salzburg, Austria (Dr Fiedler); Department of Science, Innovation and Medical Performance Development of the Austrian Pension Insurance Institution (PVA), Vienna, Austria (Dr Gruska); SKA-Rehabilitation Center Großgmain (PVA), Großgmain, Austria (Dr Altenberger); SKA-Rehabilitation Center St Radegund (PVA), Graz, Austria (Dr Dorr); Division of Cardiology and Intensive Care, Department of Medicine, Kepler University Hospital, Linz, Austria (Dr Steinwender); Division of Cardiology and Angiology, Department of Medicine, University Hospital Innsbruck, Innsbruck, Austria (Dr Stuehlinger); Private Practice for Cardiology and Sports Medicine, Graz, Austria (Dr Wonisch); and Division of Cardiac Surgery, Medical University of Graz, Graz, Austria (Zirngast)
| | - Manfred Wonisch
- Division of Internal Medicine, Department of Cardiology, Medical University of Graz, Graz, Austria (Drs Rohrer, Manninger, Zweiker, Zirlik, and Scherr and Ms Reischl); Division of Cardiology and Intensive Care, Department of Medicine, Hospital Klinikum Wels-Grieskirchen, Wels, Austria (Dr Binder); Division of Internal Medicine, Cardiology and Nephrology, Department of Medicine, Hospital Wiener Neustadt, Wiener Neustadt, Austria, and Division of Cardiology, Department of Medicine, University Hospital Salzburg, Salzburg, Austria (Dr Fiedler); Department of Science, Innovation and Medical Performance Development of the Austrian Pension Insurance Institution (PVA), Vienna, Austria (Dr Gruska); SKA-Rehabilitation Center Großgmain (PVA), Großgmain, Austria (Dr Altenberger); SKA-Rehabilitation Center St Radegund (PVA), Graz, Austria (Dr Dorr); Division of Cardiology and Intensive Care, Department of Medicine, Kepler University Hospital, Linz, Austria (Dr Steinwender); Division of Cardiology and Angiology, Department of Medicine, University Hospital Innsbruck, Innsbruck, Austria (Dr Stuehlinger); Private Practice for Cardiology and Sports Medicine, Graz, Austria (Dr Wonisch); and Division of Cardiac Surgery, Medical University of Graz, Graz, Austria (Zirngast)
| | - Birgit Zirngast
- Division of Internal Medicine, Department of Cardiology, Medical University of Graz, Graz, Austria (Drs Rohrer, Manninger, Zweiker, Zirlik, and Scherr and Ms Reischl); Division of Cardiology and Intensive Care, Department of Medicine, Hospital Klinikum Wels-Grieskirchen, Wels, Austria (Dr Binder); Division of Internal Medicine, Cardiology and Nephrology, Department of Medicine, Hospital Wiener Neustadt, Wiener Neustadt, Austria, and Division of Cardiology, Department of Medicine, University Hospital Salzburg, Salzburg, Austria (Dr Fiedler); Department of Science, Innovation and Medical Performance Development of the Austrian Pension Insurance Institution (PVA), Vienna, Austria (Dr Gruska); SKA-Rehabilitation Center Großgmain (PVA), Großgmain, Austria (Dr Altenberger); SKA-Rehabilitation Center St Radegund (PVA), Graz, Austria (Dr Dorr); Division of Cardiology and Intensive Care, Department of Medicine, Kepler University Hospital, Linz, Austria (Dr Steinwender); Division of Cardiology and Angiology, Department of Medicine, University Hospital Innsbruck, Innsbruck, Austria (Dr Stuehlinger); Private Practice for Cardiology and Sports Medicine, Graz, Austria (Dr Wonisch); and Division of Cardiac Surgery, Medical University of Graz, Graz, Austria (Zirngast)
| | - David Zweiker
- Division of Internal Medicine, Department of Cardiology, Medical University of Graz, Graz, Austria (Drs Rohrer, Manninger, Zweiker, Zirlik, and Scherr and Ms Reischl); Division of Cardiology and Intensive Care, Department of Medicine, Hospital Klinikum Wels-Grieskirchen, Wels, Austria (Dr Binder); Division of Internal Medicine, Cardiology and Nephrology, Department of Medicine, Hospital Wiener Neustadt, Wiener Neustadt, Austria, and Division of Cardiology, Department of Medicine, University Hospital Salzburg, Salzburg, Austria (Dr Fiedler); Department of Science, Innovation and Medical Performance Development of the Austrian Pension Insurance Institution (PVA), Vienna, Austria (Dr Gruska); SKA-Rehabilitation Center Großgmain (PVA), Großgmain, Austria (Dr Altenberger); SKA-Rehabilitation Center St Radegund (PVA), Graz, Austria (Dr Dorr); Division of Cardiology and Intensive Care, Department of Medicine, Kepler University Hospital, Linz, Austria (Dr Steinwender); Division of Cardiology and Angiology, Department of Medicine, University Hospital Innsbruck, Innsbruck, Austria (Dr Stuehlinger); Private Practice for Cardiology and Sports Medicine, Graz, Austria (Dr Wonisch); and Division of Cardiac Surgery, Medical University of Graz, Graz, Austria (Zirngast)
| | - Andreas Zirlik
- Division of Internal Medicine, Department of Cardiology, Medical University of Graz, Graz, Austria (Drs Rohrer, Manninger, Zweiker, Zirlik, and Scherr and Ms Reischl); Division of Cardiology and Intensive Care, Department of Medicine, Hospital Klinikum Wels-Grieskirchen, Wels, Austria (Dr Binder); Division of Internal Medicine, Cardiology and Nephrology, Department of Medicine, Hospital Wiener Neustadt, Wiener Neustadt, Austria, and Division of Cardiology, Department of Medicine, University Hospital Salzburg, Salzburg, Austria (Dr Fiedler); Department of Science, Innovation and Medical Performance Development of the Austrian Pension Insurance Institution (PVA), Vienna, Austria (Dr Gruska); SKA-Rehabilitation Center Großgmain (PVA), Großgmain, Austria (Dr Altenberger); SKA-Rehabilitation Center St Radegund (PVA), Graz, Austria (Dr Dorr); Division of Cardiology and Intensive Care, Department of Medicine, Kepler University Hospital, Linz, Austria (Dr Steinwender); Division of Cardiology and Angiology, Department of Medicine, University Hospital Innsbruck, Innsbruck, Austria (Dr Stuehlinger); Private Practice for Cardiology and Sports Medicine, Graz, Austria (Dr Wonisch); and Division of Cardiac Surgery, Medical University of Graz, Graz, Austria (Zirngast)
| | - Daniel Scherr
- Division of Internal Medicine, Department of Cardiology, Medical University of Graz, Graz, Austria (Drs Rohrer, Manninger, Zweiker, Zirlik, and Scherr and Ms Reischl); Division of Cardiology and Intensive Care, Department of Medicine, Hospital Klinikum Wels-Grieskirchen, Wels, Austria (Dr Binder); Division of Internal Medicine, Cardiology and Nephrology, Department of Medicine, Hospital Wiener Neustadt, Wiener Neustadt, Austria, and Division of Cardiology, Department of Medicine, University Hospital Salzburg, Salzburg, Austria (Dr Fiedler); Department of Science, Innovation and Medical Performance Development of the Austrian Pension Insurance Institution (PVA), Vienna, Austria (Dr Gruska); SKA-Rehabilitation Center Großgmain (PVA), Großgmain, Austria (Dr Altenberger); SKA-Rehabilitation Center St Radegund (PVA), Graz, Austria (Dr Dorr); Division of Cardiology and Intensive Care, Department of Medicine, Kepler University Hospital, Linz, Austria (Dr Steinwender); Division of Cardiology and Angiology, Department of Medicine, University Hospital Innsbruck, Innsbruck, Austria (Dr Stuehlinger); Private Practice for Cardiology and Sports Medicine, Graz, Austria (Dr Wonisch); and Division of Cardiac Surgery, Medical University of Graz, Graz, Austria (Zirngast)
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