The Safety of Home Bicycle Ergometer Exercise as Indicated by Transtelephone Electrocardiographic Responses Soon After Open-Heart Surgery

Abstract

To assess the safety of home exercise soon after open-heart surgery, 19 pts. (mean age 55.7) underwent home exercise 14 to 9% weeks postsurgery. Individualized exercise prescription heart rates and intensities were determined from a prehospital discharge submaximal exercise evaluation. Pts. performed exercise sessions daily for 8 weeks. During the first 2 week interval, pts. used heart rate monitors to transmit electrocardiograms via telephone on 5 separate days. To reevaluate the exercise prescription at 2 and 4 weeks, pts. subjectively reproduced the heart rate and the intensity of the previous exercise prescription followed by a submaximal exercise evaluation. At 8 weeks pts. performed a symptom-limited maximal exercise evaluation. For the first 2 week interval, the results indicated 1) there was no significant change in the incidence of arrhythmias in patients at rest and during home exercise, 2) the results of the predischarge exercise evaluation were consistent with the findings of the transtelephone electrocardiography heart rate and rhythm checks, 3) the heart rate responses were within the limits of the exercise prescription given to the patients, and 4) the pts., when given an exercise prescription in conjunction with the teaching of self-monitoring techniques and appropriate intensity adjustments, were able to appropriately monitor their own home exercise prescription. These findings reflect that structured and individualized home exercise beginning as soon as 10 days post open-heart surgery appears to be safe during the critical first 2 weeks. The safety may be augmented by transtelephone electrocardiography monitoring.