Comparison of the Effects of Different Upper Extremity Aerobic Exercise Training Protocols on Arm Functional Capacity in Patients With Heart Failure With Cardiac Implantable Electronic Devices

Inclusion Criteria: * Patients aged 18 and over with heart failure who are receiving Implantable Cardioverter Defibrillator (ICD) or Cardiac Resynchronization Therapy (CRT) * At least 3 months have passed since device implantation and there have been no complications at the last device control * Being in New York Heart Association (NYHA) Class II-III * Patients without cooperation problems * Patients who volunteer to participate in the study Exclusion Criteria: * Patients who have previously participated in a cardiac rehabilitation program and those who have completed less than 1 year since the program, * Patients with a primary diagnosis of cardiomyopathy and those with heart failure secondary to cardiomyopathy, * Patients with a history of shoulder pathologies that may restrict upper extremity movement before device implantation (such as severe pain around the shoulder, edema, or shoulder dislocation that restricts upper extremity movement), * Patients with a history of shoulder surgery (patients with limitations in range of motion), * Patients who have undergone mastectomy on the affected side or a cerebrovascular event resulting in arm involvement, * Patients with decompensated heart failure, * Patients with a history of ICD-incompatible shock, * Patients with a history of unstable angina pectoris, acute myocardial infarction, or cardiac surgery within the last 3 months, * Patients who have experienced acute atrial fibrillation, ventricular tachycardia, and ventricular fibrillation within the last 3 months, * Patients with actively treated malignancy or collagen tissue disease receiving systemic steroids * Patients with chronic kidney disease undergoing dialysis where volume load is unstable, * Persistent ventricular arrhythmias during baseline cardiopulmonary exercise testing.