TY - JOUR

T1 - Accelerometer-assessed physical behavior and the association with clinical outcomes in implantable cardioverter-defibrillator recipients

T2 - A systematic review

AU - Kolk, Maarten Z.H.

AU - Frodi, Diana M.

AU - Andersen, Tariq O.

AU - Langford, Joss

AU - Diederichsen, Soeren Z.

AU - Svendsen, Jesper H.

AU - Tan, Hanno L.

AU - Knops, Reinoud E.

AU - Tjong, Fleur V.Y.

N1 - Publisher Copyright: © 2021 Heart Rhythm Society

PY - 2022

Y1 - 2022

N2 - Background: Current implantable cardioverter-defibrillator (ICD) devices are equipped with a device-embedded accelerometer capable of capturing physical activity (PA). In contrast, wearable accelerometer-based methods enable the measurement of physical behavior (PB) that encompasses not only PA but also sleep behavior, sedentary time, and rest-activity patterns. Objective: This systematic review evaluates accelerometer-based methods used in patients carrying an ICD or at high risk of sudden cardiac death. Methods: Papers were identified via the OVID MEDLINE and OVID EMBASE databases. PB could be assessed using a wearable accelerometer or an embedded accelerometer in the ICD. Results: A total of 52 papers were deemed appropriate for this review. Out of these studies, 30 examined device-embedded accelerometry (189,811 patients), 19 examined wearable accelerometry (1601 patients), and 3 validated wearable accelerometry against device-embedded accelerometry (106 patients). The main findings were that a low level of PA after implantation of the ICD and a decline in PA were both associated with an increased risk of mortality, heart failure hospitalization, and appropriate ICD shock. Second, PA was affected by cardiac factors (eg, onset of atrial fibrillation, ICD shocks) and noncardiac factors (eg, seasonal differences, societal factors). Conclusion: This review demonstrated the potential of accelerometer-measured PA as a marker of clinical deterioration and ventricular arrhythmias. Notwithstanding that the evidence of PB assessed using wearable accelerometry was limited, there seems to be potential for accelerometers to improve early warning systems and facilitate preventative and proactive strategies.

AB - Background: Current implantable cardioverter-defibrillator (ICD) devices are equipped with a device-embedded accelerometer capable of capturing physical activity (PA). In contrast, wearable accelerometer-based methods enable the measurement of physical behavior (PB) that encompasses not only PA but also sleep behavior, sedentary time, and rest-activity patterns. Objective: This systematic review evaluates accelerometer-based methods used in patients carrying an ICD or at high risk of sudden cardiac death. Methods: Papers were identified via the OVID MEDLINE and OVID EMBASE databases. PB could be assessed using a wearable accelerometer or an embedded accelerometer in the ICD. Results: A total of 52 papers were deemed appropriate for this review. Out of these studies, 30 examined device-embedded accelerometry (189,811 patients), 19 examined wearable accelerometry (1601 patients), and 3 validated wearable accelerometry against device-embedded accelerometry (106 patients). The main findings were that a low level of PA after implantation of the ICD and a decline in PA were both associated with an increased risk of mortality, heart failure hospitalization, and appropriate ICD shock. Second, PA was affected by cardiac factors (eg, onset of atrial fibrillation, ICD shocks) and noncardiac factors (eg, seasonal differences, societal factors). Conclusion: This review demonstrated the potential of accelerometer-measured PA as a marker of clinical deterioration and ventricular arrhythmias. Notwithstanding that the evidence of PB assessed using wearable accelerometry was limited, there seems to be potential for accelerometers to improve early warning systems and facilitate preventative and proactive strategies.

KW - Accelerometry

KW - Implantable cardioverter-defibrillator

KW - Physical behavior

KW - Systematic review

KW - Ventricular tachyarrhythmia

UR - http://www.scopus.com/inward/record.url?scp=85126080196&partnerID=8YFLogxK

U2 - 10.1016/j.cvdhj.2021.11.006

DO - 10.1016/j.cvdhj.2021.11.006

M3 - Review

C2 - 35265934

AN - SCOPUS:85126080196

VL - 3

SP - 46

EP - 55

JO - Cardiovascular Digital Health Journal

JF - Cardiovascular Digital Health Journal

SN - 2666-6936

IS - 1

ER -