"CARDIAC DEVICE 500"– A RACE FOR LIFE: ENCOURAGING PRE-TRANSPLANT EXERCISE PARTICIPATION

SESSION TITLE: Transplantation Case Report Posters 1 SESSION TYPE: Case Report Posters PRESENTED ON: 10/10/2023 09:40 am - 10:25 am INTRODUCTION: After heart transplantation, most patients have a notable improvement in functional capacity but present lower exercise capacity resulting in a poor quality of life and a reduced ability to perform activities of daily living. Exercise-based cardiac rehabilitation (EBCR) is a measure that can improve exercise capacity in these patients; however, participation has been reported to be relatively low [1]. The use of Abiomeds Impella 5.5 and the Intra-Aortic Balloon Pump (IABP) as a bridge to transplant has allowed for more extensive physical rehab prior to transplant. We aim to describe the potential role of implementing a tracker board to increase patient participation in EBCR. CASE PRESENTATION: We aimed to encourage hospitalized patients waiting for heart transplantation who had mechanical support devices including the Impella 5.5 and IABP to increase physical activity (walking) through friendly competition. Patients are routinely recommended to walk around the floor (1 lap = 980 feet) before cardiac transplantation. Initially, we recorded the number of laps completed throughout the day on the patients' doors. After some attempts to improve this idea and make it more exciting for patients, we created the "Cardiac Device 500" tracker board. We required low-cost, easily attainable items such as flip boards and markers for these. Each patient developed a nickname that was placed on the tracker board (e.g., "Tootsie," "Mad Dog," "R2D2 2.0"). Each time patients completed a lap, they added a tally mark by their name for that day. Multiple days were shown on the board at once to show all the work and step the patients had done before the heart transplant. This approach was also patient-centered, as we recognize that each journey is patient-specific; therefore, each patient's goals differed. This tracker board was initially implemented in 5 pre-cardiac transplants with great acceptance and improved exercise capacity through their hospital stay, evidenced by the increased number of daily laps. DISCUSSION: EBCR programs increase the likelihood of restoring exercise capacity and improving mental health in heart transplant patients. However, factors related to advanced heart failure, including deconditioning, cachexia, and skeletal muscle derangements, may limit exercise capacity early post-transplant. Pre-transplantation exercise can help familiarize patients with exercise modes to incorporate into their daily lives and with minimal re-education shortly after transplantation. In addition, if the patient is in a better-conditioned state, the days of inactivity after the transplant may have a lesser impact in reversing the level of conditioning. The tracker board could be a cost-effective, non-time-consuming, and patient-friendly tool that could be used to encourage pre-cardiac transplant patients to exercise. CONCLUSIONS: The "Cardiac Device 500" tracker board could potentially increase hospitalized patient participation in exercise activities before the transplant. Further studies are required to determine its impact on postoperative outcomes. REFERENCE #1: Bachmann JM, Shah AS, Duncan MS, Greevy RA, Graves AJ, Ni S, et al. Cardiac rehabilitation and readmissions after heart transplantation. The Journal of Heart and Lung Transplantation. 2018; 37: 467–476. DISCLOSURES: No relevant relationships by Penny Amoroso Employee relationship with Abiomed Please note: 8/02/2022 - Current Added 04/06/2023 by Jessica Blasavage, source=Web Response, value=Salary No relevant relationships by Kimberly Britton No relevant relationships by Shahin Isha No relevant relationships by Sean Kiley No relevant relationships by Nikki Matos No relevant relationships by Leta Mendoza No relevant relationships by Pablo Moreno Franco No relevant relationships by Parag Patel No relevant relationships by Devang Sanghavi No relevant relationships by PARTHKUMAR SATASHIA No relevant relationships by Julie Shimp No relevant relationships by Jorge Sinclair De Frías No relevant relationships by Jill Zimmerman