Cardiac rehabilitation programs
- Lynne T Braun, PhD, RN, CNP
Lynne T Braun, PhD, RN, CNP
- UpToDate NP Advisory Board Member
- Professor of Nursing
- Rush University College of Nursing
- Nanette K Wenger, MD
Nanette K Wenger, MD
- Professor of Medicine (Cardiology)
- Emory University School of Medicine
- Robert S Rosenson, MD
Robert S Rosenson, MD
- Professor of Medicine
- Mount Sinai School of Medicine
- Director, Cardiometabolic Disorders
- Mount Sinai Heart
Outpatient cardiac rehabilitation programs provide supervised exercise training in conjunction with other secondary prevention interventions. They are designed to speed recovery from acute cardiovascular events such as myocardial infarction, myocardial revascularization, or hospitalization for heart failure and to improve quality of life. In addition, patients with stable coronary heart disease derive benefits. (See "Prevention of cardiovascular disease events in those with established disease or at high risk".)
This topic will discuss the organization and content of these programs. The indications for and the efficacy and safety of cardiac rehabilitation are discussed separately. (See "Cardiac rehabilitation: Indications, efficacy, and safety in patients with coronary heart disease".)
●Medical evaluation/baseline patient assessment
●Exercise training and physical activity counseling
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- Milani RV, Lavie CJ, Cassidy MM. Effects of cardiac rehabilitation and exercise training programs on depression in patients after major coronary events. Am Heart J 1996; 132:726.
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- King M, Bittner V, Josephson R, et al. 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. Circulation 2012; 126:2535.
- Balady GJ, Ades PA, Bittner VA, et al. Referral, enrollment, and delivery of cardiac rehabilitation/secondary prevention programs at clinical centers and beyond: a presidential advisory from the American Heart Association. Circulation 2011; 124:2951.
- Taylor RS, Dalal H, Jolly K, et al. Home-based versus centre-based cardiac rehabilitation. Cochrane Database Syst Rev 2010; :CD007130.
- Lear SA, Singer J, Banner-Lukaris D, et al. Randomized trial of a virtual cardiac rehabilitation program delivered at a distance via the Internet. Circ Cardiovasc Qual Outcomes 2014; 7:952.
- Taylor RS, Dalal H, Jolly K, et al. Home-based versus centre-based cardiac rehabilitation. Cochrane Database Syst Rev 2015; :CD007130.
- Turk-Adawi K, Grace SL. Smartphone-based cardiac rehabilitation. Heart 2014; 100:1737.
- Varnfield M, Karunanithi M, Lee CK, et al. Smartphone-based home care model improved use of cardiac rehabilitation in postmyocardial infarction patients: results from a randomised controlled trial. Heart 2014; 100:1770.
- INITIATION OF REHABILITATION
- EXERCISE TRAINING
- Risk stratification for exercise
- Frequency and duration
- Rating of perceived exertion (Borg scale)
- Exercise progression
- Resistance training
- Long-term exercise
- HEART FAILURE AND CARDIAC TRANSPLANTATION PATIENTS
- Nutritional counseling and weight management
- Cessation of smoking
- Diabetes management
- Management of hypertension and hyperlipidemia
- PSYCHOSOCIAL SUPPORT
- MEDICAL DIRECTOR RESPONSIBILITIES
- ALTERNATE APPROACHES
- INFORMATION FOR PATIENTS