Evidence map›Paper›PMID 29909402›Full record

ArticleJournal of the American Heart Association2018

Impact of Exercise Restriction on Arrhythmic Risk Among Patients With Arrhythmogenic Right Ventricular Cardiomyopathy.

Weijia Wang, Gabriela Orgeron, Crystal Tichnell, Brittney Murray, Jane Crosson, Oliver Monfredi, Julia Cadrin-Tourigny, Harikrishna Tandri, Hugh Calkins, Cynthia A James

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of the American Heart Association, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 45 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
45citing papers in PubMed, 3 pooled it
7.5field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

45 citing papers in PubMed, 3 syntheses or guidelines pooled it, 84 citations in OpenAlex.

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  11. Lifetime cumulative activity burden is associated with symptomatic heart failure and arrhythmic risk in patients with arrhythmogenic right ventricular cardiomyopathy: a retrospective cohort study.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2024
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  16. Arrhythmic risk stratification in arrhythmogenic right ventricular cardiomyopathy.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2023
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

10 authors at 1 institution in 1 country.

Weijia WangDivision of Cardiology, Department of Medicine, Johns Hopkins University, Baltimore, MD wwang95@jhu.edu.
Gabriela OrgeronDivision of Cardiology, Department of Medicine, Johns Hopkins University, Baltimore, MD.
Crystal TichnellDivision of Cardiology, Department of Medicine, Johns Hopkins University, Baltimore, MD.
Brittney MurrayDivision of Cardiology, Department of Medicine, Johns Hopkins University, Baltimore, MD.
Jane CrossonDivision of Cardiology, Department of Medicine, Johns Hopkins University, Baltimore, MD.
Oliver MonfrediDivision of Cardiology, Department of Medicine, Johns Hopkins University, Baltimore, MD.
Julia Cadrin-TourignyDivision of Cardiology, Department of Medicine, Johns Hopkins University, Baltimore, MD.
Harikrishna TandriDivision of Cardiology, Department of Medicine, Johns Hopkins University, Baltimore, MD.
Hugh CalkinsDivision of Cardiology, Department of Medicine, Johns Hopkins University, Baltimore, MD.
Cynthia A JamesDivision of Cardiology, Department of Medicine, Johns Hopkins University, Baltimore, MD.
Johns Hopkins University · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPrior studies have shown a close link between exercise and development of arrhythmogenic right ventricular cardiomyopathy. How much exercise restriction reduces ventricular arrhythmia (VA), how genotype modifies its benefit, and whether it reduces risk sufficiently to defer implantable cardioverter-defibrillator (ICD) placement in arrhythmogenic right ventricular cardiomyopathy are unknown. METHODS AND

resultsWe interviewed 129 arrhythmogenic right ventricular cardiomyopathy patients (age: 34.0±14.8 years; male: 60%) with ICDs (36% primary prevention) about exercise participation. Exercise change was defined as annual exercise duration and dose in the 3 years before clinical presentation minus that after presentation. The primary outcome was appropriate ICD therapy for VA. During the 5.1 years (interquartile range: 2.7-10.8 years) after presentation, 74% (95/129) patients reduced exercise dose and 85 (66%) patients experienced the primary outcome. In multivariate analyses, top tertile reduction in exercise duration and dose were both associated with less VA (duration: hazard ratio: 0.23 [95% confidence interval, 0.07-0.81]; dose: hazard ratio: 0.14 [95% confidence interval, 0.04-0.44]). Greater reduction in exercise dose conferred greater reduction in VA (

conclusionsExercise restriction should be recommended to all arrhythmogenic right ventricular cardiomyopathy patients with ICDs. Patients who are "gene-elusive" and those with primary-prevention devices may particularly benefit. Exercise reduction is unlikely to reduce arrhythmia sufficiently in high-risk patients to alter decision-making regarding ICD implantation.

Indexed as

ExerciseAdultArrhythmias, CardiacArrhythmogenic Right Ventricular DysplasiaClinical Decision-MakingDefibrillators, ImplantableElectric CountershockFemaleHumansMaleMiddle AgedPrimary PreventionProtective FactorsRegistriesRetrospective StudiesRisk Assessmentarrhythmogenic right ventricular cardiomyopathyexerciseimplantable cardioverter‐defibrillatorventricular tachycardia

Identifiers

PMID29909402
PMCPMC6220537
OpenAlexW2808013948

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.