Rehab After LVAD Implant Makes a Life Saver Even Better
If you’ve had an LVAD, here’s why you really should also have cardiac rehab.
Heart doctors know that cardiac rehab helps restore your strength after a heart attack or heart surgery. In 2014, cardiac rehab was also approved by Medicare for patients with heart failure.
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But until recently, no one knew about rehab’s specific benefit for patients with newly implanted continuous flow left ventricular assist devices (LVAD). A new study shows that cardiac rehab therapy improves the strength, endurance and quality of life for recent recipients of the lifesaving devices.
Advances in LVAD offer new options to patients with advanced heart failure. Gordon Blackburn, PhD, Program Director of Cardiac Rehabilitation at Cleveland Clinic, says as LVAD procedures become more common, life after LVAD surgery is an increasingly important area of study.
“LVAD surgery is a life-saving therapy for many patients with end-stage heart failure. While LVAD surgery can improve exercise capacity and health status, we have found that patients realize significant additional benefits in strength, exercise stamina and quality of life by participating in an individually tailored cardiac rehabilitation program after LVAD implant,” he says.
The new study specifically shows that rehab offers significant additional benefits in strength, stamina and quality of life.
Researchers at Henry Ford Hospital in Detroit studied outcomes of heart failure patients with newly implanted continuous-flow left ventricular assist devices. Results from their work appear in the Journal of The American College of Cardiology.
The scientists enrolled 26 patients and asked them to fill out a questionnaire (Kansas City Cardiomyopathy Questionnaire) and to participate in a fitness and strength exercise test.
After the initial tests and survey, randomly selected patients received six weeks of cardiac rehabilitation. Others received standard care but no cardiac rehab. The six-week rehabilitation program consisted of 18 separate visits that focused on moderate aerobic exercise.
Following the six-week period, patients repeated the tests and answered questionnaires. Researchers compared the baseline results with those from the six-week follow-up.
The patients who participated in cardiac rehab improved their oxygen uptake a significant 10% over the six week study period, while the non-participants demonstrated no change in oxygen uptake. The rehab group also showed more improvement in treadmill time, endurance and leg strength. Quality of life factors also improved.
Nader Moazami, MD, Surgical Director of the Cleveland Clinic Kaufman Center for Heart Failure and Director of the Cardiac Transplantation and Ventricular Assist Device Therapy Program did not participate in the Detroit study. But he says that an organized and focused rehabilitation program benefits patients who may have multiple and complex health challenges.
“Frequently, many of our LVAD patients have complex medical issues and prolonged hospitalizations. Our colleagues in our cardiac rehabilitation program have been instrumental in assisting with rehabilitation, strengthening our patients and improving their functional capacity,” Dr. Moazami says.
Rehab is an integral part of LVAD treatment, Dr. Blackburn says. “Cardiac rehabilitation should be considered as an essential component of the patient care plan.”
The short-term studies are encouraging. Researchers hope further study will provide insight into which specific types of therapy help LVAD recipients most.