Risk stratification model for telemedicine-based cardiac rehabilitation

Abstract Background Physical training (PhT) is highly cost-benefit maneuver in patients with heart disease, as a part of an integral Cardiac Rehabilitation Program. Exercise-related adverse outcomes are low, mainly due to adequate cardiovascular risk stratification and the correct prescription supervision PhT. Exercise testing (ET) cornerstone this process. Advances telecommunication technologies have boosted possibility deliver cardiac rehabilitation via internet, low cost non-face-to-face intervention. However, it not advisable perform remote stress test through digital media. Purpose The aim study estimate effect excluding exercise data from traditional model on prediction individual outcomes. Methods A cohort disease who participated outpatient hospital-based program was studied. All underwent clinical evaluation, along ET. obtained were used stratify events during physical prescribed basis. Each patient performed 30 minutes cycle ergometry, five times week, moderate effort perception (6–20 Borg scale). sessions supervised by cardiologist using continuous ECG telemetry blood pressure measurement. Resistance complemented gymnastic circuit (kinesiotherapy). bivariate logistic regression multivariable analysis or paraclinical variables that had been previously models showed statistically association outcome (traditional model). In order simulate lack test, these excluded multivariate (TELERISK), Figure 1. Results Six hundred thirty-nine No major recorded. Patients presented several minor outcomes, including arrhythmias (n=485), such sinus bradycardia, pauses, premature supraventricular complexes, tachycardia, atrial fibrillation, ventricular bigeminy, couplets non-sustained tachycardia. Other exercise-induced ischemia (n=31), hypotension (n=15), hypertensive response (n=31) dizziness (n=7). predictive capacity TELERISK significantly lower (AUC=0.661) than observed for (AUC=0.766), 2. Conclusion decreases when test. FUNDunding Acknowledgement Type funding sources: None. Telerisk Outcome ROC curve