Patients with symptomatic AS represent a unique group, as they are usually extremely limited in their ability to perform physical activity (PA) prior to an intervention. They are further limited by use of rhythm and/or rate control medications, which makes engaging in physical activity very difficult.
After the TAVI procedure, the greatest barrier to performing exercise is removed, however patients are often left severely deconditioned and often with significant limitation due to other co-morbidities.
Exercise has been shown to improve outcomes in elderly patients with a variety of cardiac disorders, but there is scarce currently available prospective data from randomised trials on exercise after TAVI.
Cardiac rehabilitation has been predominately directed towards patients with ischaemic heart disease. Chronic physical activity limitation in patients with symptomatic AS results in poor engagement in organised cardiac rehabilitation, post intervention. In Denmark, despite high availability of cardiac rehabilitation services, only half the number of patients take up the opportunity for post-intervention rehabilitation (1).
Reference:
- Hansen, T. B., Berg, S. K., Sibilitz, K. L., Søgaard, R., Thygesen, L. C., Yazbeck, A.-M., & Zwisler, A. D. (2014). Availability of, referral to and participation in exercise-based cardiac rehabilitation after heart valve surgery: Results from the national CopenHeart survey. European Journal of Preventive Cardiology, 22(6), 710–718. doi:10.1177/2047487314536364