Cardiac rehabilitation (CR) is a multi-faceted secondary prevention intervention that aims to limit the physiological and psychological effects of cardiovascular disease and to assist in the management of symptoms and a reduction of future cardiovascular risk. In this, clinical audit of all CR programmes and establishment of ­national datasets are seen as essential as a basis for checking and benchmarking and to ensure that services are being delivered effectively. Home-Based Cardiac Rehabilitation: A Scientific Statement From the American Association of Cardiovascular and Pulmonary Rehabilitation, ... and group-based social support when evidence-based behavioral change techniques are used 103, 104, 105. Their conclusions on the current evidence of best practice have been summarised in a position paper, which provides a pragmatic summary of the minimum standards, structure and function of cardiovascular prevention and rehabilitation programmes (http://www.bacpr.com/resources/AC6_BACPRStandards&CoreComponents2017.pdf) (table 1). 2016;23(18):1914–39. Access to a health coach for HBCR participants has potential to improve communication, social support, and education, which can help sustain … Early provision of a structured cardiovascular prevention and rehabilitation programme, with a defined ­pathway of care, which meets the ­individual’s goals and is aligned with patient preference and choice. https://doi.org/10.4414/cvm.2018.00545 Medical director responsibilities for outpatient cardiac rehabilitation/secondary prevention programs: 2012 update: a statement for health care professionals from the American Association of Cardiovascular and Pulmonary Rehabilitation and the American Heart Association. Hospital-based rehabilitation units. Home-Based Cardiac Rehabilitation: A Scientific Statement From the American Association of Cardiovascular and Pulmonary Rehabilitation, the American Heart Association, and the American College of Cardiology. Owing to barriers linked with programme availability and local or national regulations, further efforts are needed in order to ensure a valid choice of high-quality, evidence-based secondary prevention measures that best fit the patient’s psychosocial situation, cardiovascular risk profile and ­individual preferences. A multitude of individual studies and meta-analyses document the beneficial effects of CR programmes in patients with coronary artery disease with or without heart failure. Cardiac Rehabilitation Section EAoPCicwtIoMB, Informatics DoMBUoH, the Cochrane M, Endocrine Disorders Group IoGPH-HUDG. Continuity of care and outpatient management for patients with and at high risk for cardiovascular disease during the COVID-19 pandemic: A scientific statement from the American Society for Preventive Cardiology. Centre-based, multidisciplinary cardiac rehabilitation programmes complying with well-defined minimal requirements are the gold standard for de­livering optimal postinterventional care and achieving secondary preven­-tion goals. The official ­recognition of each CR programme by the SCPRS is a prerequisite for reimbursement by healthcare provi­ders.  |  In order to achieve the proven effectiveness of CR in routine clinical practice, the definition, implementation and continuous monitoring of accepted minimal standards for CR delivery are constantly reviewed by the BACPR. Keywords: COVID-19 is an emerging, rapidly evolving situation. Cardiovascular rehabilitation, ballroom dancing and sexual dysfunction. Early initial assessment of individual patient needs which informs the agreed personalised goals that are reviewed regularly. evidence-based cardiac rehabilitation program. Short-Term Exercise Progression of Cardiovascular Patients throughout Cardiac Rehabilitation: An Observational Study. Swiss Archives of Neurology, Psychiatry and Psychotherapy, Scientific evidence for cardiac ­rehabilitation, Minimal standards and core components of CR programmes, Barriers to the implementation of ­secondary prevention. 2020 Sep 29;9(10):3160. doi: 10.3390/jcm9103160. Electronic searches of Medline, Embase, CINAHL, science citation … For patients who have suffered myo­cardial infarction and/or undergone coronary revascularisation, attending and completing a programme of exercise-based CR is associated with an absolute risk reduction in cardiovascular mortality from 7.6 to 10.4% compared with those who do not take part in a CR programme, with a number needed to treat (NNT) of 37. The writing group carried out a systematic review of published studies of HBCR compared with CBCR to assess the comparative effectiveness and potential benefits of HBCR and to explore implementation strategies for developing HBCR programs. As the basis for the elaboration of their recommendations, the BACPR used the following definition: CR is the “coordinated sum of activities required to influence ­favourably the underlying cause of cardiovascular disease, as well as to provide the best possible physical, mental and social conditions, so that the patients may, by their own efforts, preserve or resume optimal functioning in their community and through improved health behaviour, slow or reverse progression of disease”. The summary of a thorough review of the literature and the shared analysis of gaps and a proposed plan of action is summarised in figure 1. 2019 Jul 9;74(1):133-153. doi: 10.1016/j.jacc.2019.03.008. 1 Another German physician, Peter Beckman, … However, although promising, evidence regarding the effectiveness and uptake of existing interventions is mixed. Thomas RJ, Beatty AL, Beckie TM, Brewer LC, Brown TM, Forman DE, Franklin BA, Keteyian SJ, Kitzman DW, Regensteiner JG, Sanderson BK, Whooley MA. Available literature on barriers to the accessibility of out-patient cardiac rehabilitation services were reviewed. The ESC Textbook of Preventive Cardiology. In the meantime, alternative forms of endurance training, such as ballroom dancing or, for example, exergaming [11, 12] could be considered in order to increase the attractiveness of the services and to contribute to overcoming some of the barriers to participation and long-term adherence. Several systematic reviews have explored quantitative evidence on the potential of digital interventions to support cardiac rehabilitation (CR) and self-management. Khera A, Baum SJ, Gluckman TJ, Gulati M, Martin SS, Michos ED, Navar AM, Taub PR, Toth PP, Virani SS, Wong ND, Shapiro MD. Rich MW, Chyun DA, Skolnick AH, Alexander KP, Forman DE, Kitzman DW, Maurer MS, McClurken JB, Resnick BM, Shen WK, Tirschwell DL. 2016 May 24;133(21):2103-22. doi: 10.1161/CIR.0000000000000380. Exercise-based rehabilitation for heart failure: systematic review and meta-analysis. 7 Bjarnason-Wehrens B, McGee H, Zwisler AD, Piepoli MF, Benzer W, Schmid JP, Det al. AHA Scientific Statements; behavior therapy; cardiac rehabilitation; exercise; patient education. Abstract. Regarding the situation in Switzerland, due to the short distances and a dense net of CR programmes, the need for alternative methods of CR delivery seems not to be of major importance. HHS Upon programme completion, a final assessment of individual patient needs and demonstration of sustainable health outcomes. A position paper from the Cardiac Rehabilitation Section of the European Association of Cardiovascular Prevention and Rehabilitation. Heart. The scientific evidence for cardiovascular disease prevention and rehabilitation is compelling. For a successful implementation, patients need support by means of a professional multidisciplinary team, which provides the necessary information on the type and severity of their disease, initiates the required behavioural changes, and instructs the patients on how to restart physical activity after an acute coronary event or cardiovascular surgery. Circulation. 3 Sagar VA, Davies EJ, Briscoe S, Coats AJ, Dalal HM, Lough F, et al. • new evidence of ischemia on an exercise test, including thallium scan • new, clinically significant coronary lesions documented by cardiac catheterization . [Exercise-based cardiac rehabilitation in COVID-19 times: one small step for health care systems, one giant leap for patients]. The evidence-based, cardiac rehabilitation program serves patients at 17 community sites across a large region of Ontario and includes weekly visits for six months. doi: 10.1161/JAHA.120.017075. The evidence-based, cardiac rehabilitation program serves patients at 17 community sites across a large region of Ontario and includes weekly visits for six months. Cardiac rehabilitation (CR) is an evidence-based intervention that uses patient education, health behavior modification, and exercise training to improve secondary prevention outcomes in patients with cardiovascular disease. Accessibility to those services is a major factor in the underutilisation of current programs. Although the CR community still struggles to achieve optimal service delivery, secondary prevention measures have greatly improved over recent decades. Secondary prevention through cardiac rehabilitation: from knowledge to implementation. However, because it was greatly underpowered (having recruited at best only 23% of the original predefined sample in each trial arm), RAMIT cannot be viewed as a trial of “efficacy”, that is, to demonstrate whether or not CR “works”, but as a pragmatic trial of its effectiveness as provided “in real life” [1].It raised concerns due to considerable ­differences between the centres that recruited patients with respect to content, duration, intensity and volume of the intervention offered to patients. Whereas referral after surgery or ST-segment elevation myocardial infarction (STEMI) seems to be well accepted from the ­clinician/health care provider as well as the patient side, major improvements however are still needed in patients after minor acute coronary syndromes (non-STEMI), elective percutaneous coronary interventions and heart failure. It is the process by which cardiac patients recover and readapt to reach and maintain optimal physical, sensory, intellectual, psychological and social functional levels through strategies such that they are provided with the tools to resume their ordinary activities as soon as possi… The prognostic effect of cardiac rehabilitation in the era of acute revascularisation and statin therapy: A systematic review and meta-analysis of randomized and non-randomized studies – The Cardiac Rehabilitation Outcome Study (CROS). Epub 2020 Aug 28. Home-Based Cardiac Rehabilitation: A SCIENTIFIC STATEMENT FROM THE AMERICAN ASSOCIATION OF CARDIOVASCULAR AND PULMONARY REHABILITATION, THE AMERICAN HEART ASSOCIATION, AND THE AMERICAN COLLEGE OF CARDIOLOGY . Intensive Cardiac Rehabilitation is different from the traditional cardiac rehab. This commentary provides a model for cardiac rehabilitation centers that provide patient care to meaningfully contribute to our scientific understanding of this lifestyle intervention. Cardiac Rehabilitation Section of the European Association of Cardiovascular P, Rehabilitation. This second edition of the Standards and Core Components (SCC) for Cardiovascular Disease Prevention and Rehabilitation from the British Association for Cardiovascular Prevention and Rehabilitation (BACPR) define cardiac rehabilitation (CR), operationally, through seven standards and seven core components for assuring a quality service of care using a multidisciplinary biopsychosocial … USA.gov. 1 This coverage decision was based primarily on evidence that CR provided safe and effective improvements in functional capacity and quality of life in these patients.  |  They differ from the traditional models of CR, which are generally organised in three phases (e.g., post-intervention on the ward, post-discharge and long-term), involving residential, ambulatory community-, or home-based programmes. NIH Epub 2012 Oct 22. Furthermore, the CR group was less likely to be physically active at 12 months than the control group. Eur J Prev Cardiol. Epub 2016 Apr 11. Previous randomized trials have generated low- to moderate-strength evidence that HBCR and center-based CR can achieve similar improvements in 3- to 12-month clinical outcomes. Although HBCR appears to hold promise in expanding the use of CR to eligible patients, additional research and demonstration projects are needed to clarify, strengthen, and extend the HBCR evidence base for key subgroups, including older adults, women, underrepresented minority groups, and other higher-risk and understudied groups. Arq Bras Cardiol. It provides recommendations on assessment, health behaviour-change techniques, lifestyle risk factor management, psychosocial health, vocational rehabilitation and medical risk management. Eur J Heart Fail. 2020 Mar;1:100009. doi: 10.1016/j.ajpc.2020.100009. CR programs reduce morbidity and mortality rates in adults with ischemic heart disease, heart failure, or cardiac surgery but are significantly underused, with only a minority of eligible … 2020 Nov;18(11):777-789. doi: 10.1080/14779072.2020.1816464.  |  It is clear that ineffective delivery of CR is not a problem specific to the UK, and their standards should be taken as an example for the whole of Europe. NLM However, despite of all available evidence, some doubts persist on the efficacy of CR in the modern era. Rich MW, Chyun DA, Skolnick AH, Alexander KP, Forman DE, Kitzman DW, Maurer MS, McClurken JB, Resnick BM, Shen WK, Tirschwell DL; American Heart Association Older Populations Committee of the Council on Clinical Cardiology, Council on Cardiovascular and Stroke Nursing, Council on Cardiovascular Surgery and Anesthesia, and Stroke Council; American College of Cardiology; and American Geriatrics Society. Eur J Prev Cardiol. Although a most recent meta-analysis of randomised and nonrandomised controlled studies (The Cardiac Rehabilitation Outcome Study [CROS]) confirmed a significant reduction of mortality for CR participants ­after an acute coronary syndrome or after coronary ­artery bypass surgery in prospective or retrospective cohort studies, the single randomised controlled trial available so far (RAMIT: multicentre randomised controlled trial of comprehensive cardiac rehabilitation in patients following acute myocardial infarction) showed a neutral result [5]. 9 Piepoli MF, Corra U, Dendale P, Frederix I, Prescott E, Schmid JP, et al. Cardiac rehabilitation (CR) – a comprehensive outpatient program of secondary prevention and lifestyle changes – can mitigate this burden. Please enable it to take advantage of the complete set of features! Scientific evidence for cardiac ­rehabilitation A multitude of individual studies and meta-analyses document the beneficial effects of CR programmes in patients with coronary artery disease with or without heart failure. New delivery strategies are urgently needed to improve participation. Published under the copyright license “Attribution – Non-Commercial – NoDerivatives 4.0”. Setting and delivery of preventive car-diology. Lifestyle risk factor management – Physical activity and exercise training – Healthy eating and body composition – Tobacco cessation and relapse prevention, Failure to identify and manage comorbid conditions, Poor communication between physician and others ­involved in a patient’s healthcare provision, Pressure to shorten length of hospital stay, Healthcare systems focused on acute care (hospital-based health systems), Depression, mental disease, substance abuse, Poor awareness on value of preventive measure, Low health literacy / poor awareness on ­value of preventive measure, Poorly designed preventive programmes / lack of quality control. 2016;23(18):1994–2006. Registration and submission of data to a national audit. However, only the community- and telehealth-based individualised and multifactorial models for CR were found in studies to be associated with improvements in cardiovascular disease risk factor profile similar to those with the traditional hospital-based approach. Additional information can be found here. Correspondence:Jean-Paul Schmid, MDCardiology, ­Klinik ­BarmelweidCH-5017 Barmelweidjean-paul.schmid[at]barmelweid.ch. Accordingly, the most recent European Guidelines on cardiovascular disease prevention in clinical practice state that in individuals at very high cardiovascular risk, multimodal interventions integrating medical resources with education on healthy lifestyle, physical activity and stress management, and counselling on psychosocial risk factors, are recommended with a class I, evidence A indication [4]. Date: 14.02.2018 Cardiovascular Medicine EMH Swiss medical Publishers Ltd. Farnsburgerstrasse 8 CH-4132 Muttenz Tel, B. Measures have greatly improved over recent decades existing services remain underutilised Catapano al, et al V! Existing quality indicators team, led by a qualified and competent multidisciplinary team, led by a coordinator. 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