Levels of Physical Activity and Physical Fitness in Pediatric Pacemaker Patients: A Cross-Sectional Study
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ORIGINAL ARTICLE
Levels of Physical Activity and Physical Fitness in Pediatric Pacemaker Patients: A Cross‑Sectional Study Sena Teber1 · Melda Saglam2 · Ilker Ertugrul3 · Naciye Vardar‑Yagli2 · Aslihan Cakmak2 · Ebru Calik‑Kutukcu2 · Deniz Inal‑Ince2 · Hulya Arikan4 · Tevfik Karagoz3 Received: 15 March 2020 / Accepted: 23 May 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Children with heart diseases have reduced physical activity (PA) levels relative to their peers, which in turn increases cardiovascular risk. To the best of our knowledge, physical fitness and objectively measured PA levels have not been previously studied in children with pacemakers. We evaluated PA levels and physical fitness in pediatric pacemaker patients compared to their healthy peers. Twenty-eight pediatric patients with pacemakers (15 female, 13 male; mean age 13.43 ± 3.68 years) and 24 healthy subjects (14 female, 10 male; mean age 13.08 ± 3.67 years) were included. Physical fitness was assessed using the Munich Fitness Test (MFT). SenseWear Armband metabolic Holter device was used to record the PA for 7 consecutive days. MFT total and sub-parameter scores were significantly lower in the patient group (p 0.05). Indications for pacing were congenital complete AV block (53.6%), postoperative complete AV block (operated VSD [32.1%]), operated transposition of great arteries (10.7%), and Sick Sinus Syndrome (SDD) (3.6%), all of which were treated by correction surgeries. Electrodes of the leads were endocardial in 19 patients (67.9%) and epicardial in 8 patients (28.6%). The most commonly used PM mode in the patient group was VVIR (60.7%), followed by DDDR (25%), VDD (7.1%), and DDD-AAIR (7.1%). PM lower rate limit was 62.29 ± 9.55 ppm and upper rate limit was 132.38 ± 7.68 ppm. All patients had rate responsive PMs. Echocardiographic evaluation was performed by an experienced pediatric cardiologist. All patients had normal systolic and diastolic heart functions, and none had AV valve failure or residual shunt. Brain natriuretic peptide (BNP) values were within normal range (59.40 ± 111.14 pg/mL), and all patients were in New York Heart Association (NYHA) class I. Endocardial pacing site was the septal part of the right ventricle and epicardial pacing site was the apical part of the heart close to the left ventricle. Mean QRS duration was 150 ± 40 ms, shortening fraction was 42.61 ± 6.39%, and ejection fraction was 73.67 ± 6.68%. The comparison of the physical activity results measured by SWA of patients with PM and healthy children were shown in Table 2. Patients’ total and active energy expenditure, physical activity level, total distance, number of steps, and vigorous physical activity were significantly lower than those of healthy children (p 0.05). The participants’ MFT values are shown in Table 3. MFT total score and all sub-parameter scores were significantly
Table 1 Sample characteristics of the participants Variable
Pacemaker group (n = 28) Mean ± SD
Control group (n = 24) Mean ± SD
p val
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