Peculiarities of Rehabilitation in Patients after Cardioverter Defirbillator Implantation

The Aim: To select and analyze research articles, which describe peculiarities, efficiency and safety of rehabilitation in patients after cardioverter defibrillator implantation. Objectives: 1. Compare rehabilitation programs applied to patients after cardioverter defibrillator implantation. 2. Analyze the effectiveness of rehabilitation in patients after cardioverter defibrillator implantation according to the changes in the results of the maximum oxygen consumption index (VO2max) before and after rehabilitation. 3. Analyze the safety of rehabilitation in patients after cardioverter defibrillator implantation, taking into account the frequency of arrhythmias or cardioverter defibrillator discharges during rehabilitation. Methods: A systematic review of literature was performed according to PRISMA guidelines. The search was performed in the electronic database MEDLINE (via the PubMed search system). All articles that applied rehabilitation to patients after cardioverter defibrillator implantation, evaluated its safety and efficacy, based on the change of maximal oxygen consumption index (VO2max), were appropriate. Publications were extracted by following predetermined criteria. The quality of the selected articles was assessed according to the PEDro scale. Results: In the systematic review of the literature 7 research articles were included, which made a total of 631 patients. In all examineted studies, rehabilitation was based on different medium-intensity aerobic workouts. The effectiveness of rehabilitation was studied in all articles according to the change in the VO2max index. Its positive post-rehabilitation dynamics were observed in all study groups. Rehabilitation safety was examined in 6 of 7 studies, but the reported episodes of arrhythmias or ICD shock therapies were not associated with exercise training. Conclusions: After review of all the articles, it can be stated that the cardiac rehabilitation for patients with implantable cardioverter defibrillators is safe and effective and it can significantly improve the VO2max rate and the physical capacity of such patients