Efficacy and Safety of Home-Based Cardiac Telemonitoring Rehabilitation in Patients After Transcatheter Aortic Valve Implantation: Single-Center Usability and Feasibility Study

Kohei Ashikaga; Shunichi Doi; Kihei Yoneyama; Norio Suzuki; Shingo Kuwata; Masashi Koga; Naoya Takeichi; Satoshi Watanabe; Masaki Izumo; Keisuke Kida; Yoshihiro J Akashi

doi:10.2196/45247

Efficacy and Safety of Home-Based Cardiac Telemonitoring Rehabilitation in Patients After Transcatheter Aortic Valve Implantation: Single-Center Usability and Feasibility Study

JMIR Rehabil Assist Technol. 2023 May 17:10:e45247. doi: 10.2196/45247.

Authors

Affiliations

¹ Department of Sports Medicine, St. Marianna University School of Medicine, Kawasaki, Japan.
² Department of Cardiology, St. Marianna University School of Medicine, Kawasaki, Japan.
³ Rehabilitation Center, St. Marianna University School of Medicine Hospital, Kawasaki, Japan.
⁴ Department of Pharmacology, St. Marianna University School of Medicine, Kawasaki, Japan.

PMID: 37195764
PMCID: PMC10233439
DOI: 10.2196/45247

Abstract

Background: No consensus exists on the efficacy of home-based cardiac rehabilitation (CR) in patients who have undergone transcatheter aortic valve implantation (TAVI). Additionally, there are no reports on home-based cardiac telemonitoring rehabilitation (HBTR) in patients after TAVI.

Objective: We aimed to investigate the efficacy of HBTR in patients who have undergone TAVI.

Methods: This single-center preliminary study introduced HBTR to patients after TAVI, and the efficacy outcomes of the rehabilitation method were compared to that of a historical control cohort. The historical control cohort (control group) consisted of 6 consecutive patients who underwent ordinary outpatient CR after TAVI from February 2016 to March 2020. Patients who participated in the HBTR program were only recruited after the TAVI procedure and before discharge between April 2021 and May 2022. In the first 2 weeks after TAVI, patients underwent outpatient CR and were trained using telemonitoring rehabilitation systems. Thereafter, patients underwent HBTR twice a week for 12 weeks. The control group performed standard outpatient CR at least once a week for 12 to 16 weeks. Efficacy was assessed using peak oxygen uptake (VO₂) prior to and after CR.

Results: Eleven patients were included in the HBTR group. All patients underwent 24 HBTR sessions during the 12-week training period, and no adverse events were observed. The control group participants performed 19 (SD 7) sessions during the training period, and no adverse events were observed. Participants in the HBTR and control groups had a mean age of 80.4 (SD 6.0) years and 79.0 (SD 3.9) years, respectively. In the HBTR group, preintervention and postintervention peak VO₂ values were 12.0 (SD 1.7) mL/min/kg and 14.3 (SD 2.7) mL/min/kg (P=.03), respectively. The peak VO₂ changes in the HBTR and control groups were 2.4 (SD 1.4) mL/min/kg and 1.3 (SD 5.0) mL/min/kg (P=.64), respectively.

Conclusions: Home-based CR using a telemonitoring system is a safe outpatient rehabilitation method. Its efficacy is not inferior to that of standard CR in patients who have undergone TAVI.

Trial registration: Japan Registry of Clinical Trials jRCTs032200122; https://jrct.niph.go.jp/latest-detail/jRCTs032200122.

Keywords: cardiac rehabilitation; remote; telemonitoring; telerehabilitation; transcatheter aortic valve implantation.

©Kohei Ashikaga, Shunichi Doi, Kihei Yoneyama, Norio Suzuki, Shingo Kuwata, Masashi Koga, Naoya Takeichi, Satoshi Watanabe, Masaki Izumo, Keisuke Kida, Yoshihiro J Akashi. Originally published in JMIR Rehabilitation and Assistive Technology (https://rehab.jmir.org), 17.05.2023.