Wearable Cardioverter–Defibrillator-Measured Step Count for the Surveillance of Physical Fitness during Cardiac Rehabilitation

Background: The wearable cardioverter–defibrillator (WCD) has a built-in accelerometer, which allows tracking of patients’ physical activity by remote monitoring. It is unclear whether WCD-measured physical activity, step count, and heart rate correlate with established tools for the assessment of c...

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Autores principales:	Boldizsar Kovacs, Flavia Müller, David Niederseer, Nazmi Krasniqi, Ardan M. Saguner, Firat Duru, Matthias Hermann
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	wearable cardioverter–defibrillator cardiac rehabilitation step count accelerometer heart failure Chemical technology TP1-1185
Acceso en línea:	https://doaj.org/article/def2ca85f90a49e6a34a9e2c64363f66
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spelling	oai:doaj.org-article:def2ca85f90a49e6a34a9e2c64363f662021-11-11T19:04:47ZWearable Cardioverter–Defibrillator-Measured Step Count for the Surveillance of Physical Fitness during Cardiac Rehabilitation10.3390/s212170541424-8220https://doaj.org/article/def2ca85f90a49e6a34a9e2c64363f662021-10-01T00:00:00Zhttps://www.mdpi.com/1424-8220/21/21/7054https://doaj.org/toc/1424-8220Background: The wearable cardioverter–defibrillator (WCD) has a built-in accelerometer, which allows tracking of patients’ physical activity by remote monitoring. It is unclear whether WCD-measured physical activity, step count, and heart rate correlate with established tools for the assessment of cardiopulmonary fitness such as the 6-min walk test (6MWT). Objective: To correlate measurements of patient physical activity through the WCD with a supervised 6MWT during in-patient cardiac rehabilitation (CR) and to allow their use as surrogate parameters of cardiopulmonary fitness in an out-patient setting. Methods: Consecutive patients with a history of WCD use treated at our center and an in-patient CR following an index hospitalization were included. Baseline characteristics, measurements of WCD accelerometer (median daily step count, median daily activity level), median daily heart rate, and clinically supervised 6MWT at admission and discharge of CR were obtained. Results: Forty-one patients with a mean age of 55.5 (±11.5) years were included. Thirty-five patients (85.4%) were male and 28 patients (68%) had a primary prophylactic WCD-indication. The most common underlying heart diseases were ischemic heart disease (24 patients 58.6%) and dilated cardiomyopathy (13 patients, 31.7%). Median CR duration was 20 (IQR 19.75–26.25) days. 6MWT distance increased from a mean of 329 m (±107) to 470 m (±116) during CR (<i>p</i> < 0.0001). The median daily step count and activity level increased significantly, from 5542 steps (IQR 3718–7055) to 8778 (IQR 6229–12,920, <i>p</i> < 0.0001) and median 117 <i>×</i> 10<sup>6</sup> (IQR 96 <i>×</i> 10<sup>6</sup>–142 <i>×</i> 10<sup>6</sup>) threshold value exceedance (TVE) to 146 <i>×</i> 10<sup>6</sup> TVE (IQR 110 × 10<sup>6</sup>–169 × 10<sup>6</sup>, <i>p</i> < 0.0001), respectively. The median heart rate was 74.9 bpm (IQR 65.8–84.5) and 70.2 (IQR 64.1–77.3, <i>p</i> = 0.09) at admission and discharge, respectively. Of all three parameters, median daily step count showed the best correlation to the results of the 6MWT at admission and discharge (r = 0.32, <i>p</i> = 0.04 and 0.37, <i>p</i> = 0.02, respectively). Conclusions: Remote monitoring of median daily step count as assessed by the WCD’s accelerometer showed positive correlation with the 6MWT and could serve as a surrogate for cardiopulmonary exercise capacity. Assessment of daily step count and activity level measured remotely by the WCD could help to tailor optimal exercise instruction for patients not attending CR.Boldizsar KovacsFlavia MüllerDavid NiederseerNazmi KrasniqiArdan M. SagunerFirat DuruMatthias HermannMDPI AGarticlewearable cardioverter–defibrillatorcardiac rehabilitationstep countaccelerometerheart failureChemical technologyTP1-1185ENSensors, Vol 21, Iss 7054, p 7054 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	wearable cardioverter–defibrillator cardiac rehabilitation step count accelerometer heart failure Chemical technology TP1-1185
spellingShingle	wearable cardioverter–defibrillator cardiac rehabilitation step count accelerometer heart failure Chemical technology TP1-1185 Boldizsar Kovacs Flavia Müller David Niederseer Nazmi Krasniqi Ardan M. Saguner Firat Duru Matthias Hermann Wearable Cardioverter–Defibrillator-Measured Step Count for the Surveillance of Physical Fitness during Cardiac Rehabilitation
description	Background: The wearable cardioverter–defibrillator (WCD) has a built-in accelerometer, which allows tracking of patients’ physical activity by remote monitoring. It is unclear whether WCD-measured physical activity, step count, and heart rate correlate with established tools for the assessment of cardiopulmonary fitness such as the 6-min walk test (6MWT). Objective: To correlate measurements of patient physical activity through the WCD with a supervised 6MWT during in-patient cardiac rehabilitation (CR) and to allow their use as surrogate parameters of cardiopulmonary fitness in an out-patient setting. Methods: Consecutive patients with a history of WCD use treated at our center and an in-patient CR following an index hospitalization were included. Baseline characteristics, measurements of WCD accelerometer (median daily step count, median daily activity level), median daily heart rate, and clinically supervised 6MWT at admission and discharge of CR were obtained. Results: Forty-one patients with a mean age of 55.5 (±11.5) years were included. Thirty-five patients (85.4%) were male and 28 patients (68%) had a primary prophylactic WCD-indication. The most common underlying heart diseases were ischemic heart disease (24 patients 58.6%) and dilated cardiomyopathy (13 patients, 31.7%). Median CR duration was 20 (IQR 19.75–26.25) days. 6MWT distance increased from a mean of 329 m (±107) to 470 m (±116) during CR (<i>p</i> < 0.0001). The median daily step count and activity level increased significantly, from 5542 steps (IQR 3718–7055) to 8778 (IQR 6229–12,920, <i>p</i> < 0.0001) and median 117 <i>×</i> 10<sup>6</sup> (IQR 96 <i>×</i> 10<sup>6</sup>–142 <i>×</i> 10<sup>6</sup>) threshold value exceedance (TVE) to 146 <i>×</i> 10<sup>6</sup> TVE (IQR 110 × 10<sup>6</sup>–169 × 10<sup>6</sup>, <i>p</i> < 0.0001), respectively. The median heart rate was 74.9 bpm (IQR 65.8–84.5) and 70.2 (IQR 64.1–77.3, <i>p</i> = 0.09) at admission and discharge, respectively. Of all three parameters, median daily step count showed the best correlation to the results of the 6MWT at admission and discharge (r = 0.32, <i>p</i> = 0.04 and 0.37, <i>p</i> = 0.02, respectively). Conclusions: Remote monitoring of median daily step count as assessed by the WCD’s accelerometer showed positive correlation with the 6MWT and could serve as a surrogate for cardiopulmonary exercise capacity. Assessment of daily step count and activity level measured remotely by the WCD could help to tailor optimal exercise instruction for patients not attending CR.
format	article
author	Boldizsar Kovacs Flavia Müller David Niederseer Nazmi Krasniqi Ardan M. Saguner Firat Duru Matthias Hermann
author_facet	Boldizsar Kovacs Flavia Müller David Niederseer Nazmi Krasniqi Ardan M. Saguner Firat Duru Matthias Hermann
author_sort	Boldizsar Kovacs
title	Wearable Cardioverter–Defibrillator-Measured Step Count for the Surveillance of Physical Fitness during Cardiac Rehabilitation
title_short	Wearable Cardioverter–Defibrillator-Measured Step Count for the Surveillance of Physical Fitness during Cardiac Rehabilitation
title_full	Wearable Cardioverter–Defibrillator-Measured Step Count for the Surveillance of Physical Fitness during Cardiac Rehabilitation
title_fullStr	Wearable Cardioverter–Defibrillator-Measured Step Count for the Surveillance of Physical Fitness during Cardiac Rehabilitation
title_full_unstemmed	Wearable Cardioverter–Defibrillator-Measured Step Count for the Surveillance of Physical Fitness during Cardiac Rehabilitation
title_sort	wearable cardioverter–defibrillator-measured step count for the surveillance of physical fitness during cardiac rehabilitation
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/def2ca85f90a49e6a34a9e2c64363f66
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Wearable Cardioverter–Defibrillator-Measured Step Count for the Surveillance of Physical Fitness during Cardiac Rehabilitation

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