Aerobic exercise prescription in heart failure patients with cardiac resynchronization therapy

Abstract

Exercise for heart failure patients had been shown to be beneficial in improving functional status, and was reviewed to be safe. In cases of advanced heart failure, Cardiac Resynchronization Therapy (CRT) is a promising medical option before being a heart transplant candidate. CRT itself is a biventricular pacing device, which could detect electrical aberrance in the failing heart and provide a suitable response. Studies have shown that exercise has clear benefits toward improving an overall exercise capacity of the patients. Despite its impacts, these randomized clinical trials have varying exercise regime, and until now there has not been a standardized exercise prescription for this group of patients. The nature of CRT as a pacemaker, sometimes with defibrillator, being attached to a heart failure patient, each has its own potential exercise hazards. Therefore, providing detailed exercise prescription in adjusting to the medical condition is very essential in the field of physical medicine and rehabilitation. Being classified as a high‐risk patient group, exercise challenges for the complex heart failure with CRT patients will then be discussed in this literature review, with a general aim to provide a safe, effective, and targeted exercise regime.

Abstract

It is not uncommon to face heart failure patients with cardiac resynchronization device in our daily practice. Regardless of their poor physiologic function, the main challenge is to achieve the highest possible functional outcome of this special population. Therefore, our review discussed the highlights of exercise prescription, without disregarding its safety and limitations.