Malignant ventricular arrhythmias account for a significant number of deaths annually. Improved therapies have increased survival for this patient population. These patients, however, remain at high risk due to their history of sudden cardiac death and the preponderance of poor ventricular function in this population. This high risk status may have excluded them from participation in cardiac rehabilitation programs or from undergoing exercise testing in some medical centers. Although the risk of complications, especially arrhythmias, is quite real, the experience in some centers has indicated that it is manageable. This experience and some guidelines for exercise testing and training of patients with malignant ventricular arrhythmias are reviewed in this paper.
Cardiopulmonary Rehabilitation Program, Clinical Exercise Laboratories, Division of Cardiovascular Medicine, Medical College of Wisconsin, Milwaukee, WI 53226
Submitted for publication July 1995.
Accepted for publication July 1995.
The author is grateful to Kathryn Menard-Rothe, Carol Cinquegrani, and Andrew Klapperich for the crucial roles they played over the years in the care of the arrhythmia patients and also for their insightful review of this manuscript. Additionally, the author wishes to thank Carl Foster, Mark Leitschuh, and Jan Veseth-Rogers for their reviews and Jessica Provine for typing the manuscript.
AICD is a trademark of Cardiac Pacemakers, Inc., (CPI) St. Paul, MN 55112-5798.
Address for correspondence: Thomas M. Kelly, Division of Cardiovascular Medicine, Medical College of Wisconsin, 9200 W. Wisconsin Avenue, Milwaukee, WI 53226.