Early rehabilitation after hospitalisation for an acute exacerbation of chronic heart failure

Not Applicable

Completed

• Conditions: Chronic heart failure (CHF); Circulatory System; Heart failure

• Registration Number: ISRCTN56811468
• Lead Sponsor: niversity Hospitals of Leicester NHS Trust

Brief Summary

Not available

Detailed Description

Not available

Study Timeline

• Study Start: 2010-12-08
• Last Update Posted: 5 June 2017

Recruitment & Eligibility

• Status: Completed
• Sex: All
• Target Recruitment: 56

Inclusion Criteria

1. Patients admitted to the acute medical units of the trial hospital with an acute exacerbation of chronic heart failure (CHF)
2. Able to give informed consent
3. Aged 40 - 90 years
4. Patients admitted with an established diagnosis of CHF (documented left ventricular systolic dysfunction [LVSD]) will be independently assessed for suitability
5. Patients will have received optimal medical management
6. Impaired exercise tolerance (New York Heart Association [NYHA] classifications II - IV)

Exclusion Criteria

1. Patients admitted for planned surgery
2. Patients with musculoskeletal or neuromuscular condition that significantly contributes to exercise limitation
3. Psychiatric or neurological conditions that would render the patient unable to comply with the training either in hospital or at home
4. Patients who have a new diagnosis of heart failure on admission will be excluded as they are likely to need ongoing medical management (i.e. establishing the correct drug regimen) and probably won?t display the same declines in physical activity as those with established chronic heart failure.
5. Usual exclusion criteria to our current out-patient exercise programme will apply:
5.1. Unstable ischaemic heart disease
5.2. Myocardial infarction (MI) within the previous 3 weeks
5.3. Planned coronary revascularization/pacemaker implantation in the next 6 months
5.4. New onset of atrial fibrillation (AF)
5.5. Complex ventricular arrhythmia
5.6. Significant regurgitant valvular disease requiring surgery
5.7. Moderate/severe aortic stenosis
5.8. Hypertrophic obstructive cardiomyopathy
5.9. Acute pericarditis or myocarditis
5.10. Recent embolism or thromboembolism
6. Terminal disease with an estimated survival time of less than 3 months to live. Medical advice may need to be sought in these cases.
7. Those with previous attendance at rehabilitation within the preceding 12 months. This includes CHF rehabilitation and rehabilitation for post-MI/angina/re-vascularisation.
8. We know in chronic obstructive pulmonary disease (COPD) that the benefits of rehabilitation have been shown to persist for 12 months. Due to the probability of multiple factors being present (such as inability to cope at home), patients will be excluded if they have had four or more hospitalisations for an acute exacerbation of their disease in the preceding 12-month period (currently only 1.1% of patients in UHL are readmitted more than four times within 12 months). In our experience these patients frequently have significant social and psychological problems triggering hospitalisation that would not be modifiable with the proposed intervention.

Study & Design

• Study Type: Interventional
• Study Design: Not specified