Circulation. Arrhythmia and electrophysiology · 2025
Subcutaneous Implantable Defibrillators in Young Patients: Arrhythmias, Complications, and Physical Activity.
СтатьяНазвание и аннотация: Перевод в очереди
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Francia Pietro, Ziacchi Matteo, Migliore Federico, De Filippo Paolo, Dello Russo Antonio, Viani Stefano, Rapacciuolo Antonio, Falasconi Giulio, Adduci Carmen, Bisignani Giovanni, Checchi Luca, Busacca Giuseppe, Santini Luca, Lavalle Carlo, Calvi Valeria Ilia, Curcio Antonio, Silvetti Massimo, Pangallo Antonio, Carbonaro Marco, Giorgi Davide, Pittorru Raimondo, Lovecchio Mariolina, Valsecchi Sergio, Biffi Mauro, D'Onofrio Antonio, Pelliccia Antonio, S-ICD Rhythm Detect Investigators
Аннотация
BACKGROUND: The safety of subcutaneous implantable cardioverter defibrillator (S-ICD) recipients who lead active lifestyles and engage in recreational sports is unknown. We aimed to evaluate the association between lifestyle and recreational sports and the occurrence of arrhythmia- and device-related complications, appropriate and inappropriate shocks in S-ICD recipients.
METHODS: We assessed a cohort of young-adult (15-65 years) S-ICD patients, evaluated their physical activity with IPAQ (International Physical Activity Questionnaire), and assessed the association between lifestyle and recreational sports on S-ICD safety and shocks.
RESULTS: We enrolled 602 S-ICD recipients (77% men; age, 46±14 years). According to the IPAQ, patients were categorized as inactive subjects (26.4%), moderately active subjects (45.2%), or highly active subjects (28.4%). Among moderately/highly active subjects, 163 (27.1%) were recreational athletes. During follow-up (47.3 [interquartile range, 27.0-67.6] months), 23 patients (3.8%) reached the safety end point of arrhythmia- or device-related complications, with moderately and highly active subjects showing in multivariate analysis similar incidence compared with inactive subjects (P=0.59 and P=0.83, respectively). Forty-four patients had 87 appropriate shocks. In multivariate analysis, moderately and highly active subjects showed a nonsignificantly lower incidence of appropriate shocks compared with inactive subjects (P=0.12 and P=0.11, respectively). Consistently, there was a nonsignificant lower incidence of appropriate shocks in athletes versus nonathletes (P=0.06). Thirty-nine patients had 46 inappropriate shocks. Moderately and highly active subjects had similar incidence of inappropriate shocks compared with inactive subjects (P=0.92 and P=0.88, respectively).
CONCLUSIONS: Young S-ICD patients often lead active lifestyles and participate in sports. Higher activity levels were not associated with increased implantable cardioverter defibrillator-related complications or increased risk of implantable cardioverter defibrillator shocks.
METHODS: We assessed a cohort of young-adult (15-65 years) S-ICD patients, evaluated their physical activity with IPAQ (International Physical Activity Questionnaire), and assessed the association between lifestyle and recreational sports on S-ICD safety and shocks.
RESULTS: We enrolled 602 S-ICD recipients (77% men; age, 46±14 years). According to the IPAQ, patients were categorized as inactive subjects (26.4%), moderately active subjects (45.2%), or highly active subjects (28.4%). Among moderately/highly active subjects, 163 (27.1%) were recreational athletes. During follow-up (47.3 [interquartile range, 27.0-67.6] months), 23 patients (3.8%) reached the safety end point of arrhythmia- or device-related complications, with moderately and highly active subjects showing in multivariate analysis similar incidence compared with inactive subjects (P=0.59 and P=0.83, respectively). Forty-four patients had 87 appropriate shocks. In multivariate analysis, moderately and highly active subjects showed a nonsignificantly lower incidence of appropriate shocks compared with inactive subjects (P=0.12 and P=0.11, respectively). Consistently, there was a nonsignificant lower incidence of appropriate shocks in athletes versus nonathletes (P=0.06). Thirty-nine patients had 46 inappropriate shocks. Moderately and highly active subjects had similar incidence of inappropriate shocks compared with inactive subjects (P=0.92 and P=0.88, respectively).
CONCLUSIONS: Young S-ICD patients often lead active lifestyles and participate in sports. Higher activity levels were not associated with increased implantable cardioverter defibrillator-related complications or increased risk of implantable cardioverter defibrillator shocks.