Abstract
We sought to demonstrate the impact of improved peak exercise oxygen consumption (V̇O2) during maximal exercise testing after cardiac rehabilitation (CR) on the incidence of arrhythmias in patients with heart failure (HF). The present study comprised of 220 patients with HF, and peak V̇O2 was examined at 2 and 5 months after CR. Of the 220 patients, 110 (50%) had a low peak V̇O2 of < 14 mL/min/kg at 2 months. The peak V̇O2 improved in 86 of these 110 (78%) patients at 5 months after CR. During a median follow-up of 6 years, the patients with improvement in peak V̇O2, compared to those without peak V̇O2 improvement, had a lower rate of mortality (4% vs. 29%, log-rank, P < 0.001) and HF hospitalization (6 vs. 17%, log-rank, P = 0.044) and a lower incidence of new-onset atrial arrhythmias (9 vs. 27%, log-rank, P = 0.013), with no difference in the incidence of ventricular arrhythmias between groups (1 vs. 4%, log-rank, P = 0.309). The majority of deaths in the patients without an improved peak V̇O2 were because of cardiovascular events (73%), particularly progressive HF (55%). Early detection and management of atrial arrhythmias may improve outcomes in patients without peak V̇O2 improvement after CR.
Highlights
We sought to demonstrate the impact of improved peak exercise oxygen consumption (VO2) during maximal exercise testing after cardiac rehabilitation (CR) on the incidence of arrhythmias in patients with heart failure (HF)
Mancini et al demonstrated that a low peak VO2 of < 14 mL/kg/min was associated with poor prognosis in patients with severe HF1
Impaired exercise capacity is a major symptom in patients with HF, which is represented by low peak VO2 during maximal exercise testing
Summary
We sought to demonstrate the impact of improved peak exercise oxygen consumption (VO2) during maximal exercise testing after cardiac rehabilitation (CR) on the incidence of arrhythmias in patients with heart failure (HF). Atrial and ventricular arrhythmias contribute to the morbidity and mortality of patients with HF3, the impact of improvement in exercise capacity after CR on the long-term incidence of atrial and ventricular arrhythmias remains uncertain. We hypothesized that improvement in peak VO2 after CR would reduce the risk of long-term incidence of cardiac arrhythmias and mortality in patients with HF. We sought to determine the association between the changes in exercise capacity after CR and the incidence of new-onset atrial and ventricular arrhythmias and the rate of mortality and hospitalization due to HF exacerbation during long-term follow-up
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