![]() Dual-chamber ICDs can provide quantitative and continuous daily PA and AF burden data using a remote home monitoring system, enabling accurate detection of PA changes and new-onset AF ( 15). In the present study, early changes in PA from baseline to 1 year after implantation were evaluated in patients with ICD/CRT-D implantation. To date, few studies have assessed changes in PA after ICD/CRT-D implantation. It was indicated that longitudinal decrease in PA was associated with a higher incidence of new-onset AF, resulting in worsened long-term outcomes. found PA decreased and mortality increased significantly after a newly persistent AF episode in patients with ICD ( 19). Baseline PA can also predict new-onset AF among the general population or patients with HF ( 15– 18). Low levels of baseline PA were associated with higher incidences of hospitalizations for HF, cardiac death, and all-cause mortality after ICD/CRT-D implantation ( 11, 14). Moreover, accelerometer-derived PA can be detected within the first 30–60 days to reflect the baseline PA status ( 14). PA can be measured via questionnaires to reflect an individual's functional status over the preceding years or months ( 13). Physical activity (PA) can predict the outcomes of different diseases ( 9– 12). Thus, it is essential to predict the incidence of new-onset AF and initiate anticoagulation and rate control management to improve the long-term clinical outcomes after ICD/CRT-D implantation. In patients receiving ICD or cardiac resynchronization therapy defibrillator (CRT-D) implantation, new-onset AF was also associated with a greater number of ICD shocks for ventricular arrhythmia, inappropriate shocks, hospitalizations for heart failure (HF), and increased mortality ( 5– 8). AF is associated with higher risks of ischemic stroke, cardiovascular events, hospitalizations, and all-cause mortality ( 3, 4). It was reported the prevenance of AF in patients with implantable cardioverter defibrillators (ICDs) was as high as 25% ( 2). Decreased PA was an independent risk factor for cardiac death (HR = 3.358, 95% CI: 1.880–5.996, P < 0.001) and all-cause mortality (HR = 2.803, 95% CI:1.732–4.535, P < 0.001).Ĭonclusion: PA decrease after ICD/CRT-D implantation is associated with a higher incidence of new-onset AF, resulting in worsened outcomes in cardiac death and all-cause mortality.Ītrial fibrillation (AF) is a common cardiac arrhythmia with an increasing prevalence ( 1). Patients with decreased PA had 2-fold risks of new-onset AF (hazard ratio = 1.972, 95% confidence interval : 1.352–2.877, P < 0.001) as high as those with unchanged/increased PA. Per 1% decrease in PA was associated with 12.4, 18.3, and 14.3% higher risks of new-onset AF, cardiac death and all-cause mortality, regardless of different baseline characteristics. PA at 1 year after implantation was increased compared with PA at baseline (11.97 ± 5.83% vs. ![]() Results: Over a mean follow-up of 50.3 months, 124 new-onset AF events (36.2%), 61 cardiac deaths (17.8%), and 87 all-cause deaths (25.4%) were observed in 343 patients with ICD/CRT-D implantation. New-onset AF was defined as the first atrial high-rate episode ≥1% of the daily AF burden detected after implantation. Changes in PA were considered from baseline status to 1 year after implantation. Methods: Patients receiving ICD/CRT-D implantation from SUMMIT registry were retrospectively analyzed. The association of PA changes with new-onset atrial fibrillation (AF), cardiac death and all-cause mortality was unclear in patients at high risk of sudden cardiac death. ![]()
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