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Characteristics, Therapeutic Needs, and Scope of Patients With a Continuous-Flow Left Ventricular Device Entering Cardiac Rehabilitation

A RETROSPECTIVE ANALYSIS

Hildebrandt, Anke, PhD; Willemsen, Detlev, MD; Reiss, Nils, MD, PhD; Bartsch, Petra, MD; Schmidt, Thomas, MA; Bjarnason-Wehrens, Birna, PhD

Journal of Cardiopulmonary Rehabilitation and Prevention: March 2019 - Volume 39 - Issue 2 - p 91–96
doi: 10.1097/HCR.0000000000000342
Cardiac Rehabilitation
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Background: With an increasing number of left ventricular assist devices (LVADs) being implanted, the need for adequate cardiac rehabilitation (CR) regimens meeting the special needs of these patients arises. Only a few studies have reported experience gained on this topic. Structured CR strategies are poorly implemented. The aim was to evaluate the characteristics, therapeutic needs, and scope of LVAD patients at admission to CR within a greater cohort in order to identify their special CR needs.

Methods: Retrospective single-center study; 69 LVAD patients (50.7 ± 13.6 y; 59 male; 48 HVAD; 21 HeartMate II) who completed first inpatient CR were included. Patient records were used to document relevant medical information (including the results of a 6-min walk test and a maximal isometric strength test for quadriceps femoral muscles in both legs) and the International Classification of Functioning, Disability and Health for classification of health and health-related domains.

Results: Patient characteristics demonstrated a heterogeneous group: CR was started 44 ± 38.6 d after implantation; CR duration was 28 ± 9.7 d. Despite similar etiology, physical and psychological condition was diverse, although, overall a high degree of impairment was present, especially in the body function (79.7%) and activity and participation (95.7%) domains. The results demonstrated the need for a highly individualized approach in the somatic and also in the education, psychosocial, and social therapeutic regimes.

Conclusion: The results demonstrate a heterogeneous group with a high level of impairment and special needs in many CR domains. The development and evaluation of a special highly individualized approach of CR, which meets the special needs of these patients, is needed.

Retrospective single-center study including 69 left ventricular assist device (LVAD) patients aimed to evaluate characteristics, therapeutic needs, and scope of LVAD patients at admission to cardiac rehabilitation (CR). The results demonstrated a heterogeneous group with a high level of impairment and special demands in many CR domains, resulting in a need for a highly individualized CR approach.

Department for Cardiac Rehabilitation, Schüchtermann-Klinik Bad Rothenfelde, Bad Rothenfelde, Germany (Drs Hildebrandt, Willemsen, Reiss, Bartsch, and Schmidt); and Institute of Cardiology and Sports Medicine, Department for Preventive and Rehabilitative Sport and Exercise Medicine, German Sports University Cologne, Cologne, Germany (Drs Hildebrandt, Schmidt, and Bjarnason-Wehrens).

Correspondence: Anke Hildebrandt, PhD, Institute of Cardiology and Sports Medicine, Department for Preventive and Rehabilitative Sport and Exercise Medicine, German Sport University Cologne, Am Sportpark Müngersdorf 6, 50933 Cologne, Germany (anke.hildebrandt@aol.de).

The authors declare no conflicts of interest.

Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.