J Korean Med Sci.  2013 Apr;28(4):564-568. 10.3346/jkms.2013.28.4.564.

Impact of Home-Based Exercise Training with Wireless Monitoring on Patients with Acute Coronary Syndrome Undergoing Percutaneous Coronary Intervention

• Lee YH
• Hur SH
• Sohn J
• Lee HM
• Park NH
• Cho YK
• Park HS
• Yoon HJ
• Kim H
• Nam CW
• Kim YN
• Kim KB

• KMID: 1786964
• DOI: http://doi.org/10.3346/jkms.2013.28.4.564

Abstract

Recent studies have suggested a favorable effect of cardiac rehabilitation (CR) on patients with cardiovascular disease. This study aimed to evaluate the impact of home-based exercise training with wireless monitoring on acute coronary syndrome (ACS) patients undergoing percutaneous coronary intervention (PCI). A total of 55 ACS patients undergoing PCI were randomly divided into home based exercise training with wireless monitoring cardiac rehabilitation (CR, n = 26) and usual care (UC, n = 29). Exercise capacity and quality of life (QOL) were evaluated at baseline and after 12 weeks. Change of metabolic equivalent of the tasks, maximal exercise time and QOL were significantly increased (+2.47 vs +1.43, P = 0.021; +169.68 vs +88.31 sec, P = 0.012; and +4.81 vs +0.89, P = 0.022, respectively), and the change of submaximal rate pressure product, and of submaximal rate of perceived exertion were significantly decreased (-28.24 vs -16.21, P = 0.013; and -1.92 vs -1.62, P = 0.018, respectively) in the CR group compared to the UC group after 12 weeks. CR using home-based exercise training with wireless monitoring led to improvement of exercise capacity and QOL relative to conventional care in ACS patients undergoing PCI. Our findings suggest that early scheduled CR may be considered in ACS patients undergoing PCI.

Keyword

Acute Coronary Syndrome; Cardiac Rehabilitation; Exercise Capacity; Quality of Life

MeSH Terms

Acute Coronary Syndrome/*therapy
Adult
Blood Pressure
Cellular Phone
Exercise Therapy
Female
Heart Rate
Humans
Male
Middle Aged
Percutaneous Coronary Intervention/instrumentation/*methods
Quality of Life
Treatment Outcome

Figure

• 

  Fig. 1 Wireless monitoring (HeartCall™). The HeartCall device was attached to the chest, and the ECG data was sent to the server via mobile phone.

Reference

1. Brubaker PH, Kaminsky LA, Whaley MH. Coronary artery disease: essentials of prevention and rehabilitation programs. 2002. Champaign: Human Kinetics;171–483.

2. Vonder Muhll I, Daub B, Black B, Warburton D, Haykowsky M. Benefits of cardiac rehabilitation in the ninth decade of life in patients with coronary heart disease. Am J Cardiol. 2002. 90:645–648.

3. Ahn JK, Kim C, Bang IK, Kim YJ. Effectiveness of cardiac rehabilitation on exercise capacity and ventricular function in ischemic heart disease patients. Korean J Sports Med. 2006. 24:229–236.

4. Choo J, Burke LE, Pyo Hong K. Improved quality of life with cardiac rehabilitation for post-myocardial infarction patients in Korea. Eur J Cardiovasc Nurs. 2007. 6:166–171.

5. Kim C, Lim HS, Ahn JK, Bang IK, Lee SM, Kim YJ. The reasons that cardiac patients did not participate in and drop out from the cardiac rehabilitation program. J Korean Acad Rehabil Med. 2002. 26:790–796.

6. Tygesen H, Wettervik C, Wennerblom B. Intensive home-based exercise training in cardiac rehabilitation increases exercise capacity and heart rate variability. Int J Cardiol. 2001. 79:175–182.

7. McGirr M, Rukholm E, Salmoni A, O'Sullivan P, Koren I. Perceived mood and exercise behaviors of cardiac rehabilitation program referrals. Can J Cardiovasc Nurs. 1990. 1:14–19.

8. Joshi SB. Exercise training in the management of cardiac failure and ischaemic heart disease. Heart Lung Circ. 2007. 16:S83–S87.

9. Ades PA. Cardiac rehabilitation and secondary prevention of coronary heart disease. N Engl J Med. 2001. 345:892–902.

10. Hao SC, Chai A, Kligfield P. Heart rate recovery response to symptom-limited treadmill exercise after cardiac rehabilitation in patients with coronary artery disease with and without recent events. Am J Cardiol. 2002. 90:763–765.

11. Kalapura T, Lavie CJ, Jaffrani W, Chilakamarri V, Milani RV. Effects of cardiac rehabilitation and exercise training on indexes of dispersion of ventricular repolarization in patients after acute myocardial infarction. Am J Cardiol. 2003. 92:292–294.

12. Kligfield P, McCormick A, Chai A, Jacobson A, Feuerstadt P, Hao SC. Effect of age and gender on heart rate recovery after submaximal exercise during cardiac rehabilitation in patients with angina pectoris, recent acute myocardial infarction, or coronary bypass surgery. Am J Cardiol. 2003. 92:600–603.

13. Bäck M, Wennerblom B, Wittboldt S, Cider A. Effects of high frequency exercise in patients before and after elective percutaneous coronary intervention. Eur J Cardiovasc Nurs. 2008. 7:307–313.

14. Izawa K, Hirano Y, Yamada S, Oka K, Omiya K, Iijima S. Improvement in physiological outcomes and health-related quality of life following cardiac rehabilitation in patients with acute myocardial infarction. Circ J. 2004. 68:315–320.

15. Maines TY, Lavie CJ, Milani RV, Cassidy MM, Gilliland YE, Murgo JP. Effects of cardiac rehabilitation and exercise programs on exercise capacity, coronary risk factors, behavior, and quality of life in patients with coronary artery disease. South Med J. 1997. 90:43–49.

16. Ades PA, Pashkow FJ, Fletcher G, Pina IL, Zohman LR, Nestor JR. A controlled trial of cardiac rehabilitation in the home setting using electrocardiographic and voice transtelephonic monitoring. Am Heart J. 2000. 139:543–548.