Evidence map›Paper›PMID 31397767›Full record

SynthesisJournal of cardiopulmonary rehabilitation and prevention2019

Exercise Interventions in Patients With Implantable Cardioverter-Defibrillators and Cardiac Resynchronization Therapy: A SYSTEMATIC REVIEW AND META-ANALYSIS.

Daniel A Steinhaus, Steven A Lubitz, Peter A Noseworthy, Daniel B Kramer

Abstract readMeta-AnalysisSystematic Review
In one paragraph

Synthesis in Journal of cardiopulmonary rehabilitation and prevention, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers.

0numbers the graph read from it
0cells of the map it votes in
20citing papers in PubMed
–field-weighted citation impact
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

20 citing papers in PubMed.

  1. Empowering congenital heart disease treatment: Physical activity prescription. The Italian proposal.International journal of cardiology. Congenital heart disease · 2026
    Article
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  8. Relationship between activity and sleep, as measured through a wearable accelerometer, and appropriate cardioverter defibrillator interventions: a prospective SafeHeart substudy.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
    Article
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  10. Fine grained automatic left ventricle segmentation via ROI based Tri-Convolutional neural networks.Technology and health care : official journal of the European Society for Engineering and Medicine · 2024
    Article
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  12. Article
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  20. [Research progress on cardiac rehabilitation in patients with implanted cardiac defibrillator].Sheng wu yi xue gong cheng xue za zhi = Journal of biomedical engineering = Shengwu yixue gongchengxue zazhi · 2020
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Daniel A SteinhausSaint Luke's Mid America Heart Institute, Kansas City, Missouri (Dr Steinhaus); Richard A. and Susan F. Smith Center for Outcomes Research in Cardiology, Cardiovascular Division, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts (Dr Kramer); Cardiac Arrhythmia Service, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston (Dr Lubitz); and Cardiovascular Division, Department of Medicine, Mayo Clinic, Rochester, Minnesota (Dr Noseworthy).
Steven A Lubitz
Peter A Noseworthy
Daniel B Kramer

Funding

Atrial Fibrillation: Bridging genetic discovery and clinical associationsK23HL114724 · NHLBI · MASSACHUSETTS GENERAL HOSPITAL · PI LUBITZ, STEVEN A · 2013 to 2017
$893k
Patient-Centered Outcomes of Implantable Defibrillator Therapy in Older PatientsK23AG045963 · NIA · HEBREW REHABILITATION CENTER FOR AGED · PI KRAMER, DANIEL BRUCE · 2013 to 2016
$714k
Access to Exercise Stress Testing for Elderly Native Americans in Remote LocationsR41AG049563 · NIA · ADVANCED MEDICAL ELECTRONICS CORPORATION · PI GIBSON, PAUL L · 2015 to 2015
$161k
NHLBI NIH HHS K23 HL114724NIA NIH HHS K23 AG045963NIA NIH HHS R41 AG049563
6 · The paper itself

Abstract

purposePhysical activity improves outcomes across a broad spectrum of cardiovascular disease. The safety and effectiveness of exercise-based interventions in patients with implantable cardioverter-defibrillators (ICDs) including cardiac resynchronization therapy defibrillators (CRT-Ds) remain poorly understood.

methodsWe identified clinical studies using the following search terms: "implantable cardioverter-defibrillators"; "ICD"; "cardiac resynchronization therapy"; "CRT"; and any one of the following: "activity"; "exercise"; "training"; or "rehabilitation"; from January 1, 2000 to October 1, 2015. Eligible studies were evaluated for design and clinical endpoints.

resultsA total of 16 studies were included: 8 randomized controlled trials, 5 single-arm trials, 2 observational cohort trials, and 1 randomized crossover trial. A total of 2547 patients were included (intervention groups = 1215 patients, control groups = 1332 patients). Exercise interventions varied widely in character, duration (median 84 d, range: 23-168 d), and follow-up time (median 109 d, range: 23 d to 48 mo). Exercise performance measures were the most common primary endpoints (87.5%), with most studies (81%) demonstrating significant improvement. Implantable cardioverter-defibrillator shocks were uncommon during active exercise intervention, with 6 shocks in 635 patients (0.9%). Implantable cardioverter-defibrillator shocks in follow-up were less common in patients receiving any exercise intervention (15.6% vs 23%, OR = 0.68; 95% CI, 0.48-0.80, P < .001). (Equation is included in full-text article.)O2 peak improved significantly in patients receiving exercise intervention (1.98 vs 0.36 mL/kg/min, P < .001).

conclusionIn conclusion, exercise interventions in patients with ICDs and CRT-Ds appear safe and effective. Lack of consensus on design and endpoints remains a barrier to broader application to this important patient population.

Indexed as

Defibrillators, ImplantableCardiac Resynchronization TherapyExerciseHeart FailureHumans

Identifiers

PMID31397767
PMCPMC6715540

What OpenQuestion holds

Textmetadata
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Read underepoch 390

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.