1000 Section - Cardiac Rehabilitation Combined with Skeletal Muscle Electrical Stimulation Stabilized Blood Pressure in an Elderly Patient with Heart Failure

Heart failure, hypertension, chronic kidney disease, dementia

Case Description:

Blood pressure management is crucial in heart failure, yet many patients fail to reach target levels. The hemodynamic benefits of skeletal muscle electrical stimulation (EMS) have recently been reported. We describe an elderly patient with heart failure in whom EMS stabilized blood pressure.
A 95-year-old woman was admitted for cardiac rehabilitation after acute-phase heart failure treatment. She had hypertension, chronic kidney disease, and dementia. Despite guideline-based therapy, blood pressure remained uncontrolled. EMS was applied to the thigh and lower leg muscles from the 11th hospital day for 30 minutes daily over 34 days. Blood pressure decreased from 177/68 to 119/65 mmHg, and mean arterial pressure from 104.3 to 83.0 mmHg. Near-infrared spectroscopy revealed that tissue oxygen saturation in the gastrocnemius increased from 63.3% at rest to 67.8% during EMS. The Functional Independence Measure improved from 78 to 117 points. No adverse events occurred throughout the intervention.

Discussions:

The increase in tissue oxygen saturation shows a significant correlation with increased shear stress in the more central ductus arteriosus. The increase in shear stress by EMS may promote vasodilation, resulted in reduction of blood pressure.

Conclusions:

In this case, cardiac rehabilitation combined with EMS successfully improved blood pressure and mean arterial pressure. EMS may be a safe and effective adjunctive therapy for elderly patients with heart failure.