Lockdown measures for COVID-19 outbreak and variation in physical activity in patients with heart failure and cardiac implantable devices.

Isabel Cardoso,Pedro Silva Cunha,Ana Sofia Delgado,André Lourenço,Guilherme Portugal,Rui Cruz Ferreira,Bruno Valente,Lourenço Rodrigues,Mário Martins Oliveira,Ana Abreu,Sérgio Laranjo

doi:10.1016/j.ijcha.2021.100906

Abstract

AimsThe present study analysed the patterns of physical activity pre-, during and post-lockdown measures for COVID-19 pandemic in patients with chronic heart failure (CHF) and cardiac implantable electronic devices (CIED) under remote monitoring (RM), and assessed the physical activity patterns during these periods.MethodsThe raw data from 95 patients with CHF (age 67,7 15,1 years, 71,5% male) corresponding to 2238 RM transmissions of the Medtronic Carelink™ network platform was obtained. The physical exercise profiles and the impact of the lockdown measures on the physical behaviour during and after the measures were analysed. According to the level of activity duration in the pre-lockdown, lockdown and post-lockdown periods, the patterns of behaviour were identified (non-recoverees, incomplete recoverees, recoverees and full-recoverees).ConclusionRM of CHF patients with CIED using the Carelink™ network is useful for close follow-up and identification of heart failure risk status variations. After relieving the confinement measures there were two groups of patients that did not recover the previous physical activity levels. Physical inactivity in patients with CHF can have a significant impact on outcomes.

Highlights

A pneumonia of unknown cause detected in Wuhan, China, was first reported to the World Health Organization Country Office in China on 31 December 2019
Physical activity data from the Medtronic implantable cardioverterdefibrillator (ICD)/cardiac resynchronization device (CRT) devices were extracted through Medtronic proprietary conversion of Carelink® interrogation data into an analysable format, and the company made these unpro cessed data available to our unit
Patients were considered eligible for inclusion in our analysis if they met the following criteria: non-homebound, age over 18 years, and if they were implanted with a cardio vascular implantable electronic devices (CIED) compatible with the Care LinkTM Patient Management system from Medtronic

Summary

Introduction

A pneumonia of unknown cause detected in Wuhan, China, was first reported to the World Health Organization Country Office in China on 31 December 2019. The measures imposed to various degrees across the continents have drastically restricted freedom of movement and outlawed public gatherings. On March 19, in Portugal, an emergency of public health was declared, and restrictive lockdown measures were implemented by the government to control the spread of the disease. There have been several indirect consequences of this pandemic, like the reduction in physical activity of patients with chronic heart failure (CHF). Current-generation cardio vascular implantable electronic devices (CIED) can continuously monitor patient activity through built-in accelerometers, resulting in an overview of the degree of physical activity variations during a particular time period [2] and this technology has been previously validated [3,4,5,6,7]. The data are stored in the device for a rolling 14- month period and can be extracted

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