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The dose-response association of implantable cardioverter-defibrillator (ICD) and cardiac resynchronization therapy defibrillator (CRTD)-measured PA with cardiovascular outcomes in patients at high risk of sudden cardiac death (SCD) was investigated.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Methods<\/jats:title>\n<jats:p>In total, 822 patients fulfilling the inclusion criteria were included and divided into three groups according to baseline PA tertiles: tertile 1 (&lt;\u20098.04%, <jats:italic>n<\/jats:italic>\u2009=\u2009274), tertile 2 (8.04\u201313.24%, n\u2009=\u2009274), and tertile 3 (&gt;\u200913.24%, n\u2009=\u2009274). The primary endpoint was cardiac death, the secondary endpoint was all-cause mortality.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Results<\/jats:title>\n<jats:p>During a mean follow-up of 59.7\u2009\u00b1\u200922.4\u2009months, cardiac death (18.6% vs 8.8% vs 5.5%, tertiles 1\u20133, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001) and all-cause mortality (39.4% vs 20.4% vs 9.9%, tertiles 1\u20133, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001) events decreased according to PA tertiles. Compared with patients younger than 60\u2009years old, older patients had a lower average PA level (9.6% vs 12.8%, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001) but higher rates of cardiac death (13.2% vs 8.1%, <jats:italic>P<\/jats:italic>\u2009=\u20090.024) and all-cause mortality (28.4% vs 16.7%, <jats:italic>P<\/jats:italic>\u2009&lt;\u20090.001) events. Adjusted multivariate Cox regression analyses showed that a higher tertile of PA was associated with a lower risk of cardiac death (hazard ratio (HR) 0.41, 95% confidence interval (CI): 0.25\u20130.68, tertile 2 vs tertile 1; HR 0.28, 95% CI: 0.15\u20130.51, tertile 3 vs tertile 1, <jats:italic>P<\/jats:italic><jats:sub>trend<\/jats:sub>\u2009&lt;\u20090.001). Similar results were observed for all-cause mortality. The dose-response curve showed an inverse non-linear pattern, and a significant reduction in endpoint risk was observed at the low-moderate PA level. The HR for cardiac death was reduced by half with 12.32% PA (177\u2009min), and the HR for all-cause mortality was reduced by half with 11.92% PA (172\u2009min). Subgroup analysis results indicated that older adults could benefit from PA and the range for achieving optimal benefits might be lower.<\/jats:p>\n<\/jats:sec><jats:sec>\n<jats:title>Conclusions<\/jats:title>\n<jats:p>PA monitoring may aid in long-term management of patients at high risk of SCD. More PA will generate better survival benefits, but even low-moderate PA is already good especially for older adults, which is relatively easy to achieve.<\/jats:p>\n<\/jats:sec>","DOI":"10.1186\/s12966-020-01026-2","type":"journal-article","created":{"date-parts":[[2020,9,21]],"date-time":"2020-09-21T13:03:52Z","timestamp":1600693432000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Dose-response association of implantable device-measured physical activity with long-term cardiac death and all-cause mortality in patients at high risk of sudden cardiac death: a cohort study"],"prefix":"10.1186","volume":"17","author":[{"given":"Xiaoyao","family":"Li","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuang","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keping","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Hua","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yangang","family":"Su","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiefu","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhaoguang","family":"Liang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Xu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1288-6737","authenticated-orcid":false,"given":"Shu","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2020,9,21]]},"reference":[{"issue":"14","key":"1026_CR1","doi-asserted-by":"publisher","first-page":"e91","DOI":"10.1016\/j.jacc.2017.10.054","volume":"72","author":"SM Al-Khatib","year":"2018","unstructured":"Al-Khatib SM, Stevenson WG, Ackerman MJ, Bryant WJ, Callans DJ, Curtis AB, et al. 2017 AHA\/ACC\/HRS guideline for Management of Patients with Ventricular Arrhythmias and the prevention of sudden cardiac death: a report of the American College of Cardiology\/American Heart Association task force on clinical practice guidelines and the Heart Rhythm Society. 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