Cardiac Rehabilitation: Key Points
- Authors:
- Thomas RJ.
- Citation:
- Cardiac Rehabilitation — Challenges, Advances, and the Road Ahead. N Engl J Med 2024;390:830-841.
The following are key points to remember from a review article on the benefits of cardiac rehabilitation and current barriers to participation:
- Only 25% of people who have had an eligible cardiovascular event participate in cardiac rehabilitation despite its known evidence-based benefits.
- Cardiac rehabilitation has many indications including stable angina, stable heart failure with reduced ejection fraction, post–myocardial infarction, post-revascularization by percutaneous coronary intervention or coronary artery bypass grafting, heart transplantation, and peripheral artery disease.
- It is essential to enroll patients in cardiac rehab soon after their event. Each day of delay in enrollment decreases participation by 1%.
- Cardiac rehab is far more than a supervised exercise program. It includes a thorough initial evaluation followed by a treatment plan that addresses risk factors, exercise habits, psychological health, and quality-of-life goals.
- Cardiac rehab is almost always done in a hospital outpatient setting. Home rehab was permitted during the COVID-19 pandemic, but its future is uncertain.
- Cardiac rehab is safe, with only one cardiac arrest per 1.3 million patient-hours.
- Cardiac rehab may have a small benefit in mortality, but it has a favorable cost-benefit ratio in improving quality-adjusted life-years gained.
- Improvement in utilization of cardiac rehab can be achieved with automatic referral systems.
- Home-based cardiac rehab may improve care to underserved groups. Results are likely similar.
- Some Veterans Administration data show that participation in home-based cardiac rehab decreases mortality by 36% compared to patients who do no cardiac rehab.
- There may be a role for expanding cardiac rehab to the period before a planned procedure, in addition to after the procedure.
- Much more needs to be done by providers, administrators, professional organizations, and legislators to improve participation in cardiac rehab.
Clinical Topics: Cardiovascular Care Team, Diabetes and Cardiometabolic Disease, Prevention, Exercise
Keywords: Cardiac Rehabilitation, Exercise, Patient Care Team
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