Journal of arrhythmia · 2025
Factors Influencing the Availability of Cardiopulmonary Exercise Testing for Patients Undergoing Cardiac Resynchronization Therapy in Japan.
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Kuhara Satoshi, Matsugaki Ryutaro, Itoh Hideaki, Oginosawa Yasushi, Fushimi Kiyohide, Matsuda Shinya, Saeki Satoru
Аннотация
BACKGROUND: This study aimed to investigate the implementation rate of cardiopulmonary exercise testing (CPET) in patients undergoing cardiac resynchronization therapy (CRT) or cardiac resynchronization therapy-defibrillator (CRT-D), as well as the associated factors, using real-world data.
METHODS AND RESULTS: Data from the Diagnostic Procedure Combination System in Japan (2014-2018) was analyzed. The participants were cardiac patients who underwent CRT or CRT-D device implantation (n = 3859). The primary outcome was whether CPET was performed after device implantation. Unpaired t-tests and chi-squared tests were used to compare the characteristics of the CPET (+) and CPET (-) groups. Multivariate analysis was used to identify factors associated with CPET performance. CPET was performed in 134 patients (3%). The CPET (-) group was older and had lower Barthel Index (BI) scores at discharge. CPET (+) patients had a higher rate of cardiac rehabilitation. Multivariate analysis revealed that age < 70 years and BI score ≥ 85 at discharge were associated with CPET implementation. In-hospital cardiac rehabilitation is also an important determinant.
CONCLUSIONS: The CPET implementation after CRT or CRT-D was low. Emphasizing the importance of CPET may improve these rates. Future studies should explore strategies to increase its use in this patient population.
METHODS AND RESULTS: Data from the Diagnostic Procedure Combination System in Japan (2014-2018) was analyzed. The participants were cardiac patients who underwent CRT or CRT-D device implantation (n = 3859). The primary outcome was whether CPET was performed after device implantation. Unpaired t-tests and chi-squared tests were used to compare the characteristics of the CPET (+) and CPET (-) groups. Multivariate analysis was used to identify factors associated with CPET performance. CPET was performed in 134 patients (3%). The CPET (-) group was older and had lower Barthel Index (BI) scores at discharge. CPET (+) patients had a higher rate of cardiac rehabilitation. Multivariate analysis revealed that age < 70 years and BI score ≥ 85 at discharge were associated with CPET implementation. In-hospital cardiac rehabilitation is also an important determinant.
CONCLUSIONS: The CPET implementation after CRT or CRT-D was low. Emphasizing the importance of CPET may improve these rates. Future studies should explore strategies to increase its use in this patient population.