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ventricular tachycardia in one patient during ergometric cycling . The authors emphasise the importance of adapting training programmes to the patient ’ s capabilities and clinical conditions to ensure a safe environment .
In this context , the Exercise Physiology and Training Committee and the Advanced Heart Failure Committee of the Heart Failure Association of the European Society of Cardiology presented guidelines and safety measures to reduce the risk of adverse events during EP for VAD patients [ 5 ]. They emphasise the appropriate evaluation of symptoms , clinical signs , and functional capacity to identify the most appropriate intervention , along with the proper selection of workloads and individualisation of the patient for CR . Staying below the predetermined ventilatory anaerobic threshold [ 5 ] is crucial . Continuous monitoring during each session , patient supervision , clinical adaptation , and proper VAD functioning are also important .
Limitations
It is noteworthy that the studies conducted have designs that include groups of modest sizes , possibly due to the difficulty in accessing this population , necessitating further research of this nature to provide more statistical certainty regarding intervention modalities and their benefits . The indication of CR in patients with VAD is increasing in several countries ; however , this study was limited to research written in English , potentially excluding high-quality research published in other languages .
Some reports lack clarity in EP parameters , such as volume , load , intensity , and frequency , creating a gap in the specificity of prescription for participant interventions .
Conclusions
All studies employed CPET or similar tests before and after the implementation of a CR program in VAD patients to screen participants and be objective with EP parameters , as well as to observe changes before and after CR . VO 2 peak is perhaps the most evaluated physiological parameter , reflecting cardiorespiratory fitness . Exercise intensities can be calculated with reference to VO 2 peak , VO 2 max , Wmax , HRmax , and HRR . In six studies , an aerobic training strategy was chosen , while one opted for a muscle-strengthening modality . HIIT was the most used training modality , increasing VO 2 peak in a short period compared to MICT . CR can be implemented in-hospital or on an outpatient basis , proving to be safe , with a low complication rate . More studies are needed to strengthen the field of CR in VAD patients .
Funding
This research has been funded by Dirección general de investigaciones of Universidad Santiago de Cali Under call No . 01-2024 .
Conflicts of interest The authors declare no conflict of interest .
Data availability statement All research data related to this study are included in the study .
Author contributions statement
Eleonora Giron Ruiz facilitated the methodological design and writing of the study . Jose Luis Piñeros Álvarez , Angely Paola Cerón , Carolina Castro Gómez , and Nelson Esteban Portuguez Jaramillo included articles obtained from the study search tool , filtered and selected candidate studies for inclusion , and wrote study topics . Angely Paola Cerón and Nelson Esteban Portuguez Jaramillo analysed results and described findings , guidelines , and indications already present in the literature .
Ethics approval This study did not require ethics committee approval .
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