Implanted cardioverter defibrillators

Though not all CR guidelines specifically suggest provision of cardiac rehabilitation for patients following insertion of an implanted cardioverter defib-rillator, most of this patient group will have CHD in conjunction with their arrhythmic tendency. The United Kingdom-based National Institute for

Clinical Excellence (NICE) recommends a rehabilitative approach to aftercare, which includes psychological preparation for living with an implanted cardioverter defibrillator (NICE, 2000). For most cardiac rehabilitation programmes, the numbers of patients seen with an implanted cardioverter defib-rillator are likely to be small. Nevertheless, it is important that these patients receive appropriate CR. It has been acknowledged that there should be larger multi-centred studies on this group (NICE, 2000). There is some evidence that comprehensive CR is safe for patients with implanted cardioverter defibrilla-tors and can improve exercising ability and lower levels of psychological distress (Fitchet, et al, 2003; Vanhees, et al., 2004).

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