Frontiers in cardiovascular medicine · 2026
Case Report: Whole-body electrical muscle stimulation as an adjunctive tool in cardiac rehabilitation of a patient with heart failure and reduced ejection fraction.
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Sendrowski Damian, Polańska-Szczap Agata, Hus Beata, Vlaieva Anastasiia, Markowski Szymon, Carlé-Calo Abraham, Kozłowski Dariusz
Аннотация
BACKGROUND: Whole-body electrical muscle stimulation (WB-EMS) is an emerging modality that simultaneously activates multiple large muscle groups via a wearable electrode suit. Although localized neuromuscular electrical stimulation (NMES) has demonstrated efficacy as an adjunctive strategy in cardiac rehabilitation (CR), WB-EMS has not previously been investigated in patients with heart failure and reduced ejection fraction (HFrEF) undergoing CR.
CASE DESCRIPTION: A 73-year-old male with recurrent non-ST-elevation myocardial infarction (NSTEMI), chronic heart failure (LVEF 20%-25%), and New York Heart Association class III was admitted for a 24-day inpatient CR programme. Standard CR (cycle ergometry, treadmill, resistance exercises, respiratory physiotherapy, and education, five days/week) was augmented with WB-EMS (Wiems Revolution Pro; 85 Hz bipolar, 350 μs, 4 s on/4 s off, 20 min sessions) three times per week (ten sessions). Safety was monitored with serial creatine kinase (CK), high-sensitivity troponin I (hs-TnI), N-terminal pro-brain natriuretic peptide (NT-proBNP), C-reactive protein (CRP), and venous blood gas with lactate, measured before and 2-3 h after each session.
OUTCOMES: A modest, age-appropriate improvement in functional capacity was accompanied by substantial reverse left-ventricular remodelling: LVEF improved from 27% to 54% (Simpson biplane); peak workload from 66 to 97 W (+47%); six-minute walk test distance from 390 to 590 m (+51%); peak oxygen uptake from 17.42 to 19.02 mL/min/kg (+9.2%); and EQ-5D-5L visual analogue scale from 60 to 90/100. Pre-exercise NT-proBNP fluctuated across the ten sessions (range 318.3-1,019.3 pg/mL); the final-day rise to 1,019.3 pg/mL likely reflected greater training effort on the last exercise day, supported by the concurrently highest post-session venous lactate of the programme (4.4 mmol/L; Δ + 2.9 mmol/L). One-month International Physical Activity Questionnaire data demonstrated sustained increases in daily physical activity. CK, hs-TnI, CRP, and venous lactate remained within acceptable safety limits, with no clinical adverse events attributable to WB-EMS.
DISCUSSION: To our knowledge, this is the first report of WB-EMS combined with standard CR in an HFrEF patient. Comprehensive serial biomarker monitoring confirmed a favorable safety profile. Improvements across functional, echocardiographic, and quality-of-life domains are promising but require confirmation in randomized trials, as multiple concurrent therapeutic interventions preclude causal attribution to WB-EMS alone.
CASE DESCRIPTION: A 73-year-old male with recurrent non-ST-elevation myocardial infarction (NSTEMI), chronic heart failure (LVEF 20%-25%), and New York Heart Association class III was admitted for a 24-day inpatient CR programme. Standard CR (cycle ergometry, treadmill, resistance exercises, respiratory physiotherapy, and education, five days/week) was augmented with WB-EMS (Wiems Revolution Pro; 85 Hz bipolar, 350 μs, 4 s on/4 s off, 20 min sessions) three times per week (ten sessions). Safety was monitored with serial creatine kinase (CK), high-sensitivity troponin I (hs-TnI), N-terminal pro-brain natriuretic peptide (NT-proBNP), C-reactive protein (CRP), and venous blood gas with lactate, measured before and 2-3 h after each session.
OUTCOMES: A modest, age-appropriate improvement in functional capacity was accompanied by substantial reverse left-ventricular remodelling: LVEF improved from 27% to 54% (Simpson biplane); peak workload from 66 to 97 W (+47%); six-minute walk test distance from 390 to 590 m (+51%); peak oxygen uptake from 17.42 to 19.02 mL/min/kg (+9.2%); and EQ-5D-5L visual analogue scale from 60 to 90/100. Pre-exercise NT-proBNP fluctuated across the ten sessions (range 318.3-1,019.3 pg/mL); the final-day rise to 1,019.3 pg/mL likely reflected greater training effort on the last exercise day, supported by the concurrently highest post-session venous lactate of the programme (4.4 mmol/L; Δ + 2.9 mmol/L). One-month International Physical Activity Questionnaire data demonstrated sustained increases in daily physical activity. CK, hs-TnI, CRP, and venous lactate remained within acceptable safety limits, with no clinical adverse events attributable to WB-EMS.
DISCUSSION: To our knowledge, this is the first report of WB-EMS combined with standard CR in an HFrEF patient. Comprehensive serial biomarker monitoring confirmed a favorable safety profile. Improvements across functional, echocardiographic, and quality-of-life domains are promising but require confirmation in randomized trials, as multiple concurrent therapeutic interventions preclude causal attribution to WB-EMS alone.