Monitoring cardiac symptoms during teleprehabilitation prior to coronary artery bypass grafting: a digital cardiac counselling trial subanalysis.

Abstract

Aims: The purpose of this subanalysis was to explore whether or not teleprehabilitation leads to worsening cardiac symptoms in patients accepted for coronary artery bypass grafting (CABG).

Methods and results: A subgroup of patients accepted for CABG (including off-pump and minimally invasive) who were randomized between teleprehabilitation and standard care in DCC trial were included. Teleprehabilitation patients had access to blended care supported by online modules, including nutritional support, functional exercise training, smoking cessation, inspiratory muscle training, and psychological support. All patients were weekly telemonitored for cardiac symptoms using a customized digital platform. This cohort included 155 patients. Baseline characteristics, including NYHA and CCS class, were balanced, except for shorter preoperative waiting times in weeks (15.0 [9.8-22.2] vs. 12.5 [7.0-16.0]) in the teleprehabilitation group. There was no significant difference in incidence of major adverse cardiac events in the preoperative period. There were 141 patients (77 control; 64 teleprehabilitation) with at least one symptom monitoring entry. A total of 373/1786 (21%) entries indicated worsening of cardiac symptoms. The distribution was right-skewed and did not significantly differ between the two groups. There was no statistically significant difference in time to event between control and teleprehabilitation for any cardiac symptom (P = 0.529), angina (P = 0.167), or dyspnoea (P = 0.334).

Conclusion: Teleprehabilitation does not lead to worsening cardiac symptoms before CABG. We postulate that teleprehabilitation, which includes low-intensity physical training, can be safely offered to patients undergoing elective CABG.