Exercise and Sport in Patients with Cardiac Implantable Electronic Device

The term cardiac implantable electronic devices (CIEDs) includes pacemakers (PMs), implantable cardioverter-defibrillators (ICDs), and cardiac resynchronization therapy (CRT) devices, which are established treatments for cardiac arrhythmias and heart failure with reduced ejection fraction. Advances in the CIED treatment have increased the number of patients with cardiovascular disease (CVD) receiving CIED. In general, low physical activity was associated with a higher risk of cardiac or all-cause death in patients with CIED. CIED recipients are considered eligible for exercise programs to improve prognosis due to underlying heart disease, to facilitate psychological adaptation to living with the device, to better evaluate the performance of their devices and, in ICD patients, to reduce their risk of receiving an inappropriate shock. The studies have shown that exercise training improves exercise performance in patients with CIED without increasing the risk of adverse events. Detailed clinical evaluation, a personalized exercise plan, appropriate device programming, and regular follow-up are essential for ensuring that CIED patients perform safe and effective exercises tailored to their specific needs. Participating in sports is another important issue for most patients with CIEDs. Recent guidelines recommend that people with a CIED be encouraged to participate in sports activities unless there is a contraindication due to underlying heart disease. It is generally accepted that leisure-time sports activity of low and moderate intensity is safe and clinically recommended for most individuals with a CIED, however individual recommendations may vary significantly, depending on the patient’s cardiovascular health, the effect of sports on their underlying disease, and the type of implanted device.