The Future of Exercise-Based Cardiac Rehabilitation for Patients With Heart Failure

Passantino, Andrea; Dalla Vecchia, Laura Adelaide; Corrà , Ugo; Scalvini, Simonetta; Pistono, Massimo; Bussotti, Maurizio; Gambarin, Fabiana Isabella; Scrutinio, Domenico; La Rovere, Maria Teresa

Cardiac rehabilitation (CR) is a comprehensive program that includes exercise training, titration of medical therapy, lifestyle modification, educational support, and psychosocial assessment. All these components are safe and beneficial resulting in significant improvements in quality of life, functional capacity, mortality, and hospital readmission. Current guidelines support its use in a broad spectrum of cardiac disease. This review focuses on exercise-based CR for heart failure (HF) patients in whom CR is a recommended treatment. Exercise should be prescribed according to a personalized approach, optimizing, and tailoring the rehabilitative program to the patient's characteristics. Specific CR programs are dedicated to older patients, those with HF and preserved ejection fraction, and recipients of cardiac implantable electronic devices or left ventricular assistance device. Telemedicine may increase CR participation and overcome some of the barriers that limit its utilization.