Dr. Korea University Anam Hospital Seoul, Seoul-t'ukpyolsi, Republic of Korea
Objectives: To evaluate the safety and feasibility of a remote electrocardiogram (ECG) monitoring-based cardiac rehabilitation (CR) program during the early postoperative period in patients with cardiac surgery.
Design: Five days after cardiac surgery, patients were referred to CR department and participated in an inpatient CR program while wearing an ECG monitoring device. The patients engaged in aerobic and resistance exercises during the three-week home-based CR period. The ECG data was transmitted to researchers, who closely monitored it and provided prompt patient feedback through a mobile application. Grip strength, 6-minute walk distance (6MWD), EuroQol-5 dimension (EQ5D), short-form 36-item health survey (SF36), and Korean Activity Scale/Index (KASI), Squat endurance tests and CPET were measured at three different time points: 5 days post-surgery, pre-discharge, and two weeks after discharge.
Results: Sixteen patients (75 % male, average age of 63.38 ± 1.89 years) completed the study. During the study, the ECG monitoring period increased from 125.25 ± 51.32 hours to 179.44 ± 17.17 hours. During first week, the median recorded APC count was 261.0, and the median detected VPC count was 135.5. By the third week, the median APC count was 155.5, and the median VPC count was 88.5. AF was observed in 5 patients, and non-fatal VT was reported in 6 patients. Peak VO2 improved from 12.39±0.57 to 17.93 ±1.25 ml/kg/min (p< 0.01). The squat endurance test improved from 16.69±2.31 to 21.81±2.31 (p< 0.01). The hand grip strength test improved from 28.30±1.66 to 30.40±1.70kg (p=0.02) and the 6MWD increased from 249.33±20.92 to 387.02±22.77m (p< 0.01). EQ5D and SF36 improved from 0.59±0.03 to 0.82±0.03 (p< 0.01) and from 83.99±3.40 to 122.82±6.06 (p< 0.01). KASI improved from 5.44±0.58 to 26.11±2.70 (p< 0.01).
Conclusions: Our findings suggest that early CR with remote ECG monitoring seems to be safe and feasible for patients with cardiac surgery.
