Abstract 15849: Exercise Training in Patients With Implantable Cardioverter Defibrillator: A Meta-analysis of Efficacy and Safety Outcomes

Abstract

Introduction: Implantable cardioverter defibrillators have been shown to improve survival, however, many patients with ICDs experience fear of shocks and avoid physical activity. Little data exist on efficacy and safety of exercise training in heart failure patients with ICDs. We performed a meta-analysis of currently available randomized clinical trials to assess the efficacy and safety of exercise training in this patient population. Methods: Randomized clinical trials that evaluated the efficacy of exercise training in patients with ICDs were included in the pooled meta-analysis. Primary efficacy outcome was change in cardiorespiratory fitness measured as peak oxygen uptake during a maximal treadmill test (CRF, mL/kg/ per minute). Primary safety outcome was difference in proportion of patients experiencing ICD shocks between exercise and control groups. Results: We included study level data from 1,532 patients (812 in exercise group and 720 in control group) derived from 5 studies which met the inclusion criteria. In the pooled analysis (figure panel 1), patients with ICD undergoing exercise training had significantly improved CRF [Weighted mean difference (95% CI): 1.86 ml/kg/min (0.71 to 3.01)]. There was also a significant reduction in the likelihood of ICD shocks (figure panel 2) in the exercise group compared to control group [Pooled odds ratio (95% CI): 0.71 (0.55 to 0.92)]. Conclusion: Exercise training is associated with significant improvements in CRF levels and reduction in the likelihood of ICD shocks among patients with ICDs.