Prevalence and Risk Factors of Serious Arrhythmia during 6-minute Walk Test in Phase II Cardiac Rehabilitation
Keywords:
prevalence, arrhythmia, six-minute walk test, cardiac rehabilitationAbstract
Objectives: To determine the prevalence and associated risk factors of serious arrhythmia indicating six-minute walk test (6MWT) termination in phase II cardiac rehabilitation patients.
Study design: Cross-sectional, analytic retrospective study.
Setting: Outpatient cardiac rehabilitation clinic, Phramongkutklao Hospital, Bangkok, Thailand.
Subjects: Cardiac patients conducted the 6MWT with electrocardio-graphy (ECG) telemetry before commencing phase II cardiac rehabilitation program from June 2015 to March 2017.
Methods: Medical records were collected from cardiac patients conducted the first 6MWT within 12 weeks after the onset of cardiac event, cardiac surgery, or cardiac intervention. ECG telemetry was monitored at before, during and 3 minutes after the test to determine the prevalence of serious arrhythmia indicating 6MWT termination. Patients’ data were analyzed to identify associated risk factors of serious arrhythmia occurrence.
Results: The data from 178 cardiac patients were collected and 143 males (80.3%) were included with mean age of 60.2 (SD 14) years old. There were 159 (89.3%), 17 (9.5%), and 2 (1.1%) patients receiving cardiac surgery, percutaneous coronary intervention (PCI) and other diagnosis, respectively. Prevalence of serious cardiac arrhythmia during 6MWT was 13.48% (24 patients) including paired premature ventricular contraction (PVC) (41.7%), frequent multifocal PVC (41.7%), ventricular tachycardia (VT) (8.3%) and a new onset atrial fibrillation (AF) (8.3%). The statistically significant associated risk factor for serious arrhythmia was only the presence of arrhythmia before 6MWT (adjusted odds ratio=5.88, p = 0.018, 95%CI 1.36-25.54).
Conclusion: Prevalence of serious arrhythmia indicating 6MWT termination was 13.48%. The presence of arrhythmia before test was statistically significant associated risk factor with 5.88 times increase in risk. Therefore, safety during 6MWT in phase II cardiac rehabilitation should be concerned.
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