Provision of rehabilitation services to patients with implanted cardioverter defibrillators: a survey of UK implantation centres

This study investigated the current level of provision of cardiac rehabilitation (CR) for automatic implanted cardioverter defibrillator (ICD) patients in the UK, the clinical and technical staff views on the need for such a service, and the current level of provision and the most commonly reported barriers to meeting these needs. The study was carried out via a postal questionnaire survey of all NHS implantation centres for ICD patients.
The majority of respondents (99%) believed they should provide rehabilitation for their patients, but only 14 (36%) centres had a programme for rehabilitation that ICD patients could access and only four (10%) of these were specifically designed for ICD patients. The majority of respondents (74%) believed they were not meeting their patients’ needs for rehabilitation. The most commonly endorsed barriers to providing and developing CR services were limited multidisciplinary staff, a wide geographical catchment area, and administrative and organisation difficulties. There was wide support for the potential of using a home-based, remotely monitored, rehabilitation package. This shows that the vast majority of staff in implantation centres agree with the recent NICE recommendations that there is an unmet need to provide CR for ICD patients.