Home-based cardiac rehabilitation was found to be noninferior to traditional center-based programs, supporting the home-based approach as an effective and feasible alternative for patients with well-treated heart failure (HF), according to results from the EXIT-HF randomized controlled trial, published Jan. 29 in JACC: Heart Failure.

Cristine Schmidt, PhD, et al., enrolled 120 patients (age 62±11 years, 66% men, mean LVEF 36±11%), randomizing 45 to the center-based rehabilitation program and 75 to the home-based program. The study's primary outcome was change in peak oxygen uptake (VO₂peak) at 12 weeks.

Following the 12-week program, patients participating in the home-based program had a clinically and statistically significant increase in VO₂peak (1.40±2.33 mL/kg/min; p<0.001), while patients assigned to the center-based program exhibited a nonsignificant increase (0.58±2.31 mL/kg/min; p=0.15). Results showed no significant between-group differences in VO₂peak change from baseline to week 12 (0.8 mL/kg/min; 95% CI, 1.8 to –0.16 mL/kg/min; p=0.10).

There were also no between-group differences among several secondary outcomes including six-minute walking distance, Minnesota Living with Heart Failure Questionnaire scores, disease-related biomarkers and physical fitness. The authors note exercise adherence to the home-based vs. center-based rehabilitation program was also similar at 84% vs. 81%, respectively.

"Our results are consistent with the published reports that favorably evaluated home-based [cardiac rehabilitation] programs in HF populations," write the authors. "Our study adds evidence supporting the effectiveness of home-based interventions to HF patients receiving optimal contemporary drug treatment, patients with implanted cardiac devices and patients across the left ventricular ejection fraction spectrum."