Patients with Reduced Ejection Fraction Heart Failure and Cardiac Implantable Electronic Devices

Not applicable- observational study

Upper extremity anaerobic capacity will be assessed using the medicine ball throw test. Each patient will be asked to sit with one hand on their chest and throw a 2 kg medicine ball forward with the other hand. After the throw, the spot where the ball first touches the ground will be marked. Scores will be measured in centimeters, then the arithmetic mean will be calculated and recorded.

Upper extremity aerobic capacity will be assessed using a arm ergometer test. The arm height of the ergometer will be set at shoulder level while seated. After the initial measurements are taken, the arm ergometer will be turned at a load of 0 watts and a speed of 60-75 rpm, and the load will be increased by 10 W every 2 minutes. The peak load reached by the patient will be recorded in watts.

The UULEX contain 8 horizontal levels. Each level is 84 cm wide and 8 cm high, with a distance of 15 cm between level centers. The lowest line corresponds to the participant's knee level. The participant holds a 0.2 kg plastic bar with their arms shoulder-width apart and moves it from the hips toward different levels. Each movement starts at the participant's hip joint and ends at the hip joint. After completing the first level for 2 minutes, the next levels are performed for 1 minute each. The bar is lifted up to 30 times per minute to the beat of a metronome. When participants reach their maximum height, the 0.2 kg bar is replaced with a 0.5 kg bar. They continue lifting to the maximum height with this weight. Then, the weight is increased by 0.5 kg every minute up to 2 kg. The time individuals can perform the test, the maximum weight they reach, and the level achieved will be recorded.

The ULIFT is a performance test based on the Glittre test, developed to assess upper extremity functional capacity. ULIFT aims to objectively measure upper extremity function, endurance, and capacity for participation in activities of daily living, particularly through lifting movements and range of motion. Participants stand in front of shelves and, using one hand, carry three objects (weighing 1 kg each) from the top shelf (at shoulder height) to the bottom shelf (at waist height) and then from the bottom shelf to the floor; the objects are then returned to the bottom shelf and then to the top shelf. Participants repeat the task five times and are instructed to perform the task as quickly as possible. The test will be administered for both upper extremities. Test duration is recorded in seconds.

The New York Heart Association (NYHA) functional classification levels will be determined. NYHA classifies heart patients clinically from 1 to 4 based on their functional status. It is a strong prognostic indicator and risk factor.