Rationale:

At present, the occurrence of serious cardiovascular complications during exercise training of cardiac patients is not well known. Published data are old and patient management (whether medical, interventional or surgical) has substantially progressed since then.

Objectives and Methodology:

In 2003, the Working Group [left pointing guillemet]Functional Exploration and Cardiac Rehabilitation[right pointing guillemet] of the French Society of Cardiology sent questionnaires to 65 French Rehabilitation centers in order to establish a prospective multicenter register of complications during rehabilitation. Any serious event occurring during or just after a supervised training session or an exercise stress test (<1 hour) was notified if it needed prompt medical intervention such as resuscitation, intravenous therapy or immediate transfert.

Results:

25420 patients, with a mean age of 61.3 and including 78% of men, were involved. They accumulated 743,471 patient hours of exercise and 42,419 exercise stress tests. 8,079 patients underwent coronary artery bypass graft (CABG), 5,089 percutaneous transluminal coronary angioplasty (PTCA), 3116 were other coronary patients, 4,350 underwent valvular surgery and 2,941 were other non-coronary patients. 14 centers reported 20 complications. 5 occurred during tests (1 cardiac arrest, 1 occlusion of stent) necessitating 3 PTCA. 15 complications occurred during training: 1 cardiac arrest due to complete atrioventricular block, 8 thoracic pain including 2 occlusions of stent, requiring 5 PTCA, 4 ventricular arrhythmias and 2 others.

Conclusion:

Neither fatal complication nor defibrillation were reported. The average cardiac arrest rate is very low (1.3 per million patient hours of participation). No complication occurs after CABG, but recently implanted stents require special supervision, although the rate of occlusion of stent during exercise is very low (0.07%).