Anti-Arrhythmic Effects of Exercise After an Implantable Defibrillator (ICD)

植入式除颤器 (ICD) 后运动的抗心律失常作用

基本信息

批准号：
7426489
负责人：
CYNTHIA M DOUGHERTY
金额：
$ 73.7万
依托单位：
UNIVERSITY OF WASHINGTON
依托单位国家：
美国
项目类别：
财政年份：
2007
资助国家：
美国
起止时间：
2007-07-01 至 2012-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7426489
关键词：
Aerobic Aerobic Exercise Affect Age Age Factors Anti-Arrhythmia Agents Anxiety Arrhythmia Autonomic nervous system Belief Cardiac Cardiopulmonary Cardiovascular Diseases Cardiovascular system Caring Cessation of life Clinical Trials Design Defibrillators Development Distress EFRAC Event Exercise Exercise stress test Future Gender Goals Health Health Personnel Heart Arrest Heart Diseases Heart Rate Home environment Hour Implant Implantable Defibrillators Individual Inflammation Interleukin-6 Intervention K-Series Research Career Programs Life Maintenance Mediating Mental Depression Modeling Monitor Morbidity - disease rate Numbers Outcome Outcome Study Parasympathetic Nervous System Patients Personal Satisfaction Persons Pilot Projects Population Populations at Risk Predisposition Quality of life Randomized Randomized Clinical Trials Randomized Controlled Clinical Trials Recurrence Regulation Research Research Personnel Resuscitation Risk Role SF-36 Sampling Secondary Prevention Shock Symptoms Telephone Testing Theoretical model Time Training Tumor Necrosis Factor-alpha Ventricular Ventricular Arrhythmia Ventricular Fibrillation Ventricular Tachycardia Walking Week conditioning cost cysteine rich protein design health related quality of life human TNF protein improved innovation mortality prescription document prescription procedure prevent programs psychological distress psychosocial treatment effect

项目摘要

DESCRIPTION (provided by applicant): The long term goal of this research is to design exercise interventions to reduce major adverse cardiac events (cardiac morbidity and mortality) and costs of care in individuals who have ventricular arrhythmias with an implantable cardioverter defibrillator (ICD). The goal of this study is to determine if an aerobic exercise intervention in addition to usual care, will significantly improve cardiopulmonary function, cardiac autonomic activity, and quality of life while reducing ventricular arrhythmias, inflammation, and psychological distress in patients with ventricular arrhythmias who have an ICD for the secondary prevention of sudden cardiac arrest (SCA). Aerobic exercise is known to increase parasympathetic cardiovascular regulation and reduce cardiac mortality. In our pilot study, we demonstrated that aerobic conditioning, strenuous enough to improve cardiopulmonary function, could be safely implemented in this population. The specific aims of this study are to test the hypotheses that: 1) aerobic exercise (5 hours/week for 8 weeks home walking at 60- 80% of peak V02 HR followed by 16 weeks of exercise maintenance) compared to usual care alone will increase cardiopulmonary function (peak V02), 2) aerobic exercise will increase cardiac autonomic activity (heart rate variability (HRV) and health related quality of life (SF-36 and Patient Concerns), while reducing ventricular arrhythmias (ICD shocks, VF/VT), psychological distress (anxiety and depression), and inflammation (hsCRP, BNP, TNF-alpha, IL-6); and 3) aerobic exercise will mediate effects on outcomes through improvement in cardiopulmonary function. Using a randomized clinical trial format, an aerobic exercise program in addition to usual care will be tested against usual care alone. The exercise intervention is designed to be conducted at home after a cardiopulmonary exercise test, using careful telephone and Polar Heart rate monitoring. The primary analysis for treatment effect is improvement in cardiopulmonary function at the end of 8 weeks. Longitudinal effects of the program will be assessed at 6 months. Secondarily, describing the effects of aerobic exercise on other outcomes will be determined. Study findings are expected to be useful clinically in making exercise prescriptions after an ICD and to be generalizable to populations at risk for recurrent SCA who have an ICD.

描述（由申请人提供）：这项研究的长期目标是设计运动干预措施，以减少患有心律不齐的患者的心脏心律不齐的患者的主要不良心脏事件（心脏发病率和死亡率），并具有植入式心律不足的心律失常（ICD）。这项研究的目的是确定除常规护理外的有氧运动干预措施是否会显着改善心肺功能，心脏自主神经活动和生活质量，同时减少心律失常患者的心室心律不齐，炎症和心理困扰，患有心室心律失常的患者，患有ICD的患者患有ICD，患有ICD的突发性心脏预测（SCA）。已知有氧运动会增加副交感神经性心血管调节并降低心脏死亡率。在我们的试点研究中，我们证明了有氧运动，足以改善心肺功能的有氧运动可以安全地在该人群中实施。 The specific aims of this study are to test the hypotheses that: 1) aerobic exercise (5 hours/week for 8 weeks home walking at 60- 80% of peak V02 HR followed by 16 weeks of exercise maintenance) compared to usual care alone will increase cardiopulmonary function (peak V02), 2) aerobic exercise will increase cardiac autonomic activity (heart rate variability (HRV) and health related quality of life (SF-36 and Patient Concerns),减少心律不齐（ICD冲击，VF/VT），心理困扰（焦虑和抑郁）以及炎症（HSCRP，BNP，TNF-Alpha，IL-6）和3）有氧运动会通过改善Cardopulmonary功能来介导对企业的影响。使用随机临床试验格式，仅针对通常的护理，还将对有氧运动计划进行有氧运动计划。锻炼干预旨在使用仔细的电话和极地心率监测后在心肺运动测试后在家中进行。治疗效果的主要分析是8周结束时心肺功能的改善。该计划的纵向影响将在6个月后评估。其次，将确定有氧运动对其他结果的影响。预计研究结果将在临床上在ICD后进行运动处方，并且可以推广到患有ICD的经常性SCA风险的人群。