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Patient Activity and Survival Following Implantable Cardioverter-Defibrillator Implantation: The ALTITUDE Activity Study

BACKGROUND: Physical activity data are collected automatically by implantable cardioverter-defibrillators (ICDs). Though these data potentially provide a quantifiable and easily accessible measure of functional status, its relationship with survival has not been well studied. METHODS AND RESULTS: Pa...

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Autores principales: Kramer, Daniel B, Mitchell, Susan L, Monteiro, Joao, Jones, Paul W, Normand, Sharon-Lise, Hayes, David L, Reynolds, Matthew R
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley & Sons, Ltd 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4599410/
https://www.ncbi.nlm.nih.gov/pubmed/25979902
http://dx.doi.org/10.1161/JAHA.115.001775
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author Kramer, Daniel B
Mitchell, Susan L
Monteiro, Joao
Jones, Paul W
Normand, Sharon-Lise
Hayes, David L
Reynolds, Matthew R
author_facet Kramer, Daniel B
Mitchell, Susan L
Monteiro, Joao
Jones, Paul W
Normand, Sharon-Lise
Hayes, David L
Reynolds, Matthew R
author_sort Kramer, Daniel B
collection PubMed
description BACKGROUND: Physical activity data are collected automatically by implantable cardioverter-defibrillators (ICDs). Though these data potentially provide a quantifiable and easily accessible measure of functional status, its relationship with survival has not been well studied. METHODS AND RESULTS: Patients enrolled in the Boston Scientific LATITUDE remote monitoring system from 2008 to 2012 with ICDs were eligible. Remote monitoring data were used to calculate mean daily activity at baseline (30 to 60 days after implantation), and longitudinally. Cox regression was used to examine the association between survival and increments of 30 minutes/day in both (1) mean baseline activity and (2) time-varying activity, with both adjusted for demographic and device characteristics. A total of 98 437 patients were followed for a median of 2.2 years (mean age of 67.7±13.1 years; 71.7% male). Mean baseline daily activity was 107.5±66.2 minutes/day. The proportion of patients surviving after 4 years was significantly higher among those in the most versus least active quintile of mean baseline activity (90.5% vs. 50.0%; log-rank P value, <0.001). Lower mean baseline activity (i.e., incremental difference of 30-minutes/day) was independently associated with a higher risk of death (adjusted hazard ratio [AHR], 1.44; 95% confidence interval [CI], 1.427 to 1.462). Time-varying activity was similarly associated with a higher risk of death (AHR, 1.48; 95% CI, 1.451 to 1.508), indicating that a patient having 30 minutes per day less activity in a given month has a 48% increased hazard for death when compared to a similar patient in the same month. CONCLUSIONS: Patient activity measured by ICDs strongly correlates with survival following ICD implantation.
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spelling pubmed-45994102015-10-16 Patient Activity and Survival Following Implantable Cardioverter-Defibrillator Implantation: The ALTITUDE Activity Study Kramer, Daniel B Mitchell, Susan L Monteiro, Joao Jones, Paul W Normand, Sharon-Lise Hayes, David L Reynolds, Matthew R J Am Heart Assoc Original Research BACKGROUND: Physical activity data are collected automatically by implantable cardioverter-defibrillators (ICDs). Though these data potentially provide a quantifiable and easily accessible measure of functional status, its relationship with survival has not been well studied. METHODS AND RESULTS: Patients enrolled in the Boston Scientific LATITUDE remote monitoring system from 2008 to 2012 with ICDs were eligible. Remote monitoring data were used to calculate mean daily activity at baseline (30 to 60 days after implantation), and longitudinally. Cox regression was used to examine the association between survival and increments of 30 minutes/day in both (1) mean baseline activity and (2) time-varying activity, with both adjusted for demographic and device characteristics. A total of 98 437 patients were followed for a median of 2.2 years (mean age of 67.7±13.1 years; 71.7% male). Mean baseline daily activity was 107.5±66.2 minutes/day. The proportion of patients surviving after 4 years was significantly higher among those in the most versus least active quintile of mean baseline activity (90.5% vs. 50.0%; log-rank P value, <0.001). Lower mean baseline activity (i.e., incremental difference of 30-minutes/day) was independently associated with a higher risk of death (adjusted hazard ratio [AHR], 1.44; 95% confidence interval [CI], 1.427 to 1.462). Time-varying activity was similarly associated with a higher risk of death (AHR, 1.48; 95% CI, 1.451 to 1.508), indicating that a patient having 30 minutes per day less activity in a given month has a 48% increased hazard for death when compared to a similar patient in the same month. CONCLUSIONS: Patient activity measured by ICDs strongly correlates with survival following ICD implantation. John Wiley & Sons, Ltd 2015-05-15 /pmc/articles/PMC4599410/ /pubmed/25979902 http://dx.doi.org/10.1161/JAHA.115.001775 Text en © 2015 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell. http://creativecommons.org/licenses/by-nc/4.0/ This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
spellingShingle Original Research
Kramer, Daniel B
Mitchell, Susan L
Monteiro, Joao
Jones, Paul W
Normand, Sharon-Lise
Hayes, David L
Reynolds, Matthew R
Patient Activity and Survival Following Implantable Cardioverter-Defibrillator Implantation: The ALTITUDE Activity Study
title Patient Activity and Survival Following Implantable Cardioverter-Defibrillator Implantation: The ALTITUDE Activity Study
title_full Patient Activity and Survival Following Implantable Cardioverter-Defibrillator Implantation: The ALTITUDE Activity Study
title_fullStr Patient Activity and Survival Following Implantable Cardioverter-Defibrillator Implantation: The ALTITUDE Activity Study
title_full_unstemmed Patient Activity and Survival Following Implantable Cardioverter-Defibrillator Implantation: The ALTITUDE Activity Study
title_short Patient Activity and Survival Following Implantable Cardioverter-Defibrillator Implantation: The ALTITUDE Activity Study
title_sort patient activity and survival following implantable cardioverter-defibrillator implantation: the altitude activity study
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4599410/
https://www.ncbi.nlm.nih.gov/pubmed/25979902
http://dx.doi.org/10.1161/JAHA.115.001775
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