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Heart Vessels. 2017 Apr;32(4):408-418. doi: 10.1007/s00380-016-0897-8. Epub 2016 Oct 11.

Internet-based training of coronary artery patients: the Heart Cycle Trial.

Author information

1
Clinic for Cardiac and Pulmonary Rehabilitation, Rosenquelle, Kurbrunnenstraße 5, 52077, Aachen, Germany. erik.skobel@rosenquelle.de.
2
Department of Cardiology, Angiology, Pneumology and Intensive Care, Medicine, University Hospital, RWTH Aachen University, Pauwelsstrasse 30, 52074, Aachen, Germany. erik.skobel@rosenquelle.de.
3
Department of Cardiology, Maastricht University Medical Centre, Maastricht, The Netherlands.
4
ITACA Institute, Polytechnic University of Valencia, Valencia, Spain.
5
Life Supporting Technologies, Departamento de Tecnología Fotónica y Bioingeniería, Universidad Politécnica de Madrid, Madrid, Spain.
6
Department of Cardiology, Angiology, Pneumology and Intensive Care, Medicine, University Hospital, RWTH Aachen University, Pauwelsstrasse 30, 52074, Aachen, Germany.
7
Centre Suisse d'Electronique et de Microtechnique SA, 2002, Neuchâtel, Switzerland.
8
Servicio de Cardiología, Hospital Clínico Universitario San Carlos de Madrid, Madrid, Spain.
9
Clinical Trial Center Aachen, Aachen, Germany.
10
Institute for Cardiology and Sports Medicine, German Sports University Cologne, Cologne, Germany.
11
Hull-York Medical School, University of Hull, Hull, UK.
12
Department of Cardiology, Spire Hull and East Riding Hospital, Hull, UK.

Abstract

Low adherence to cardiac rehabilitation (CR) might be improved by remote monitoring systems that can be used to motivate and supervise patients and tailor CR safely and effectively to their needs. The main objective of this study was to evaluate the feasibility of a smartphone-guided training system (GEX) and whether it could improve exercise capacity compared to CR delivered by conventional methods for patients with coronary artery disease (CAD). A prospective, randomized, international, multi-center study comparing CR delivered by conventional means (CG) or by remote monitoring (IG) using a new training steering/feedback tool (GEx System). This consisted of a sensor monitoring breathing rate and the electrocardiogram that transmitted information on training intensity, arrhythmias and adherence to training prescriptions, wirelessly via the internet, to a medical team that provided feedback and adjusted training prescriptions. Exercise capacity was evaluated prior to and 6 months after intervention. 118 patients (58 ± 10 years, 105 men) with CAD referred for CR were randomized (IG: n = 55, CG: n = 63). However, 15 patients (27 %) in the IG and 18 (29 %) in the CG withdrew participation and technical problems prevented a further 21 patients (38 %) in the IG from participating. No training-related complications occurred. For those who completed the study, peak VO2 improved more (p = 0.005) in the IG (1.76 ± 4.1 ml/min/kg) compared to CG (-0.4 ± 2.7 ml/min/kg). A newly designed system for home-based CR appears feasible, safe and improves exercise capacity compared to national CR. Technical problems reflected the complexity of applying remote monitoring solutions at an international level.

KEYWORDS:

Cardiac rehabilitation; Exercise training; Monitoring

PMID:
27730298
DOI:
10.1007/s00380-016-0897-8
[Indexed for MEDLINE]
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