Tag Archives: physical activity

Introduction Atrial fibrillation (AF) is the most common cardiac arrhythmia with an estimated prevalence in the UK of 3%.1 Epidemiological studies have shown a 12–20% reduction in the risk of AF in individuals who engage in guideline-recommended physical activity levels.2,3 However, the reduction in AF risk appears to diminish with increasing doses of exercise, with contemporary data proposing a paradoxical rise in the risk of AF with the highest doses of exercise; suggesting a U-shaped dose-response relationship (figure 1).4 Figure 1. The extreme exercise hypothesis4 whereby the benefits of exercise are reduced in extreme training volumes

Background One of the consequences of cardiovascular disease may be a limitation of physical activity, as a result of pain (e.g. in patients with angina) or inadequate cardiac output (e.g. in patients with heart failure). While the benefits of regular physical activity for secondary prevention in cardiovascular disease are well recognised,1 declines in physical activity may indicate a change in clinical status of a patient, whether this is in relation to cardiovascular diseases, such as heart failure,2 or the more general wellbeing of the patient. Thus, one measure of disease severity is to assess the objective exercise capability of patient

Introduction Hypertrophic cardiomyopathy (HCM) predominantly results from genetic variants that affect cardiac sarcomeres. The result is a heterogeneous condition characterised by ventricular hypertrophy that cannot be explained by increased afterload (i.e. arterial hypertension, aortic stenosis). Various hypothesised mechanisms were potentially responsible for a perceived increased risk of arrhythmia during exercise in patients with HCM: dynamic left ventricular outflow tract obstruction (LVOTO) increasing left ventricular pressure and strain; sympathetic vagal imbalance; microvascular ischaemia and metabolic acidosis.1 Subsequent internatio

Currently, UK, US and World Health Organization (WHO) aerobic guidelines all advocate at least 150 minutes weekly of moderate-to-vigorous physical activity (MVPA) in at least 10-minute bouts for adults and older adults,1,5,6 though the bout requirement is currently under debate,6 and even small amounts of physical activity provide protective health benefits. Walking is by far the most common physical activity, a brisk pace (approximately 3 mph, 5 km/hr) counts as MVPA, and walking is considered a ‘near-perfect’ exercise, with ability to gradually increase frequency and intensity with low risk of harm, while encouraging environmental sust

A new portable monitoring device (CardioMessenger Smart, Biotronik) has been launched in the USA. Roughly the size of a smartphone, the device keeps pacemaker, implantable cardioverter defibrillator, and insertable cardiac monitor patients connected to their physician remotely. The device automatically transmits daily reports of cardiac activity via worldwide cellular networks to physicians without intervention from the patient. It also provides fully customisable alerts that can be programmed to the physician’s specifications. Studies have found that home monitoring can significantly reduce hospitalisation, stroke and mortality. The manuf