Cardiac rehabilitation is a component of heart failure (HF) management but its effect on ventricular arrhythmias is not well recognized. We analyzed the antiarrhythmic effect of a 9-week hybrid comprehensive telerehabilitation (HCTR) and its influence on long term cardiovascular mortality in HF patients taken from TELEREH-HF trial.

Material and methods:
We evaluated the presence of non-sustained ventricular tachycardia (nsVT) and frequent premature ventricular complexes≥10 beats/hour (PVCs≥10) in 24-hour ECG monitoring at baseline and after 9-week HCTR or usual care(UC) of 773 HF patients (NYHA I-III, LVEF≤40%). Functional response for HCTR was assessed by changes-delta(Δ) in peak oxygen consumption(pVO2) as a result of comparing pVO2 from the beginning and the end of the program.

Among 143 patients with nsVT, arrhythmia subsided in 30.8% after HCTR, similarly among 165 patients randomized to UC who had nsVT 34.5% did not show them after 9 weeks (p=0.481). There was no significant difference in the decrease in PVC≥10 over 9 weeks between randomization arms (14.9%vs17.8%, respectively p=0.410). Functional response for HCTR in ΔpVO2>2.0 ml/kg/min did not affect occurrence of arrhythmias. Multivariable analysis did not identify HCTR as an independent factor determining improvement of nsVT or PVCs≥10. However, only in HCTR group, the achievement of the antiarrhythmic effect significantly reduced the cardiovascular mortality in 2-year follow-up (p<0.001).

Significant improvement in physical capacity after 9 weeks of HCTR did not correlate with the antiarrhythmic effect in terms of incidence of nsVT or PVCs≥10. An antiarrhythmic effect after the 9-week HCTR affected long term cardiovascular mortality in HF patients.