Rehabilitation Reduces Depression After Cardiac Arrest

Introduction: Over 70,000 Americans are discharged from the hospital after surviving cardiac arrest (CA) each year. CA survivors experience depressive symptoms that adversely affect quality of life. Exercise, facilitated through cardiac rehabilitation (CR), improves mood after traumatic brain injury. CR is inconsistently offered to CA survivors but may improve recovery. Aims: Determine if: 1) CA survivors receiving CR have less severe depressive symptoms than CA survivors who do not receive CR, and 2) CA survivors receiving CR have less severe depressive symptoms after CR than before. Methods: Chart review including CA survivors between 2016-2019 who received CR or were enrolled in the control arm of a randomized trial in which depression was assessed prospectively. Demographic and cardiac arrest characteristics were recorded for all patients. The Patient Health Questionnaire (PHQ-9) used to quantify depressive symptoms in CR participants at the beginning and end of 12-36 sessions of CR. PHQ-9 was also assessed 6 months after hospital discharge in control subjects. We compared PHQ-9 within and between groups using t-tests. Results: We included 25 patients (15 male), with mean age 54 (SD 17) years, 16 of whom CR and 9 of whom were enrolled in the trial’s control arm. In patients who received CR, PHQ-9 score decreased from a mean of 5 (SD 5) before CR to mean of 1 (SD 1) after CR [difference -4 (95% CI -4 to -1; p=0.01)]. Among patients who received CR, mean PHQ-9 after CR was lower than that of controls 6 months after discharge [control group mean 6 (SD 5); difference -5 (95% CI -9 to -2; p=0.001)]. Conclusions: CR may improve depressive symptoms in CA survivors. Future studies should investigate other benefits, dose-response and optimal timing of CR.