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Is Exercise Training Safe and Beneficial in Patients Receiving Left Ventricular Assist Device Therapy?

Alsara, Osama MD; Perez-Terzic, Carmen MD, PhD; Squires, Ray W. PhD; Dandamudi, Sanjay MD; Miranda, William R. MD; Park, Soon J. MD; Thomas, Randal J. MD, MS

Journal of Cardiopulmonary Rehabilitation & Prevention: July/August 2014 - Volume 34 - Issue 4 - p 233–240
doi: 10.1097/HCR.0000000000000050
Clinical and Scientific Reviews: Scientific Review

Because a limited number of patients receive heart transplantation, alternative therapies, such as left ventricular assist device (LVAD) therapy, have emerged. Published studies have shown that LVAD implantation, by itself, improves exercise tolerance to the point where it is comparable to those with mild heart failure. The improvement in exercise capacity is maximally achieved 12 weeks after LVAD therapy and can continue even after explantation of the device. This effect varies, depending on the type of LVAD and exercise training. The available data in the literature on safety and benefits of exercise training in patients after LVAD implantation are limited, but the data that are available suggest that training trends to be safe and have an impact on exercise capacity in LVAD patients. Although no studies were identified on the role of cardiac rehabilitation programs in the management of LVAD patients, it appears that cardiac rehabilitation programs offer an ideal setting for the provision of supervised exercise training in this patient group.

While studies have shown exercise to be safe and beneficial for patients with heart failure, little is known about exercise training in patients receiving left ventricular assist device therapy. We review the safety and impact of exercise training in patients with heart failure, who are receiving left ventricular assist device therapy.

Department of Internal Medicine, Michigan State University, East Lansing (Dr Alsara); Department of Internal Medicine, Division of Cardiovascular Diseases and Internal Medicine, Cardiovascular Health Clinic, Rochester, Minnesota (Drs Perez-Terzic, Squires, and Thomas); and Department of Physical Medicine and Rehabilitation (Dr Perez-Terzic), Department of Internal Medicine, Division of General Internal Medicine (Drs Dandamudi and Miranda), and Department of Surgery, Division of Cardiovascular Surgery (Dr Park), Mayo Clinic, Rochester, Minnesota.

Correspondence: Randal J. Thomas, MD, MS, Department of Internal Medicine, Division of Cardiovascular Diseases and Internal Medicine, Cardiovascular Health Clinic, Mayo Clinic, 200 F St, Rochester, MN 55905 (thomas.randal@mayo.edu).

The authors declare no conflicts of interest.

© 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins