Exercise-based cardiac rehabilitation for adults with implantable cardioverter defibrillators

Sudden cardiac death due to cardiovascular disease is a significant public health concern worldwide. In recent years, there has been an improvement in the mortality rates of patients who have received an implantable cardioverter defibrillator (ICD), as either a primary or secondary prevention strategy for sudden cardiac death (Nielsen et al, 2019). The mechanisms by which ICD prevents sudden death is anti-tachycardia pacing, high-voltage shock therapy or both (Nielsen et al, 2019).

It is well known that patients with heart conditions (such as post-myocardial infarction and heart failure) have improved outcomes when they receive formal cardiac rehabilitation. However, there is limited evidence and guidance to support cardiac rehabilitation in patients with an ICD (Nielsen et al, 2019).

The purpose of Nielsen et al's review (2019) was to evaluate the benefits and harms of exercise-based cardiac rehabilitation programmes, delivered alone or in combination with psychoeducation components in adults (18 years or older) with an ICD for the prevention of sudden cardiac death (regardless of whether the ICD was for primary or secondary prevention).