Predictors of arrhythmia in patients with heart failure of hybird comprehensive telerehabilitation
Objective To analyze the predictive factors for arrhythmia in patients with heart failure(HF)after 9 weeks of hybird comprehensive telerehabilitation(HCTR)and its influence on cardiovascular mortality during long-term follow-up.Methods A total of 300 HF patients who were admitted to the Department of Cardiology of the First Affiliated Hospital of University of South China from January 2020 to July 2021 were randomly divided into observation group(9-week HCTR,n=150)and control group(9-week routine care,n=150)by random number table method.The incidence of arrhythmia and cardiovascular mortality were compared between the two groups.The patients were divided into arrhythmia group and non-arrhythmia group according to the occurrence of arrhythmia.The predictive factors for arrhythmia were investigated.Results The incidence of arrhythmia was 13.33%(20/150)and 22.67%(34/150)in the observation group and control group,respectively,with a statistically significant difference(P<0.05).The proportions of patients with high N-terminal pro-brain natriuretic peptide(NT-proBNP)(Tertile 3),ischemic HF,peak oxygen consumption(pVO2)<14.0 ml/kg/min,and cardiac resynchronization(CRT),and the proportion of patients without implantable cardioverter defibrillator(ICD)or amiodarone in the arrhythmia group were significantly higher than those in the non-arrhythmia group(all P<0.05).Logistic regression analysis showed that high NT-proBNP,ischemic HF,pVO2<14.0 ml/kg/min,absence of ICD and amiodarone therapy,and CRT were significantly correlated with the occurrence of arrhythmia(all P<0.05).Cardiovascular death occurred in 2 patients(1.33%)in the observation group and 3 patients(2.00%)in the control group during 2 years of follow-up,with no statistical difference(P>0.05).Conclusion There is a low risk of arrhythmia after 9 weeks of HCTR in HF patients,and the incidence of cardiovascular death is very low during long-term follow-up.High NT-proBNP,ischemic HF,pVO2<14.0 ml/kg/min,absence of ICD and amiodarone therapy,and presence of CRT are predictive factors for arrhythmia,and they can serve as references of HCTR in HF patients,helping to optimize training regimen and further reduce cardiovascular risks.
NETL
NSTL
万方数据
