Efficacy of Different Exercise Modalities in Patients with Implantable Cardiac Devices: A Systematic Review

Abstract

Introduction: heart failure is one of the most prevalent diseases, generally managed through a medical-surgical approach with the placement of implantable cardiac devices (ICDs). Cardiac rehabilitation in these patients involves various physical exercises that focus on improving quality of life. This study aimed to gather information to determine the exercise modality with the best short-term clinical outcomes, that are also appropriate to patients with ICDs.Methods: a systematic literature review was conducted by searching for clinical studies in the Scopus, PubMed, ScienceDirect, and SpringerLink databases from 2019 to March 2024. Medical Subject Headings (MeSH) terms were employed, and the search followed PRISMA guidelines.Results: ten Randomized Clinical Trials (RCTs) were identified; one trial addressed patients with pacemakers (PM), one study included subjects with implantable cardioverter-defibrillators (ICD), three trials focused on patients with cardiac resynchronization therapy (CRT), three studies involved subjects with both ICD and CRT, and two trials included patients with left ventricular assist devices (LVAD). A total of 379 subjects participated, of which 291 were in the exercise intervention group. Four exercise modalities were found: interval aerobic, moderate continuous, combined (resistance and strength), and High-intensity interval training (HIIT).Conclusions: combined resistance and strength training was determined as the modality with the best short-term clinical outcomes for patients with implantable cardiac devices