Cardiac rehabilitation supported as an integral part of treatment

Cardiac rehabilitation has been identified as a crucial component in the comprehensive management of cardiovascular diseases, according to the European Society of Cardiology's (ESC) new 2026 guidelines. This broadened approach extends beyond the traditional post-treatment phase, incorporating elements such as risk factor management, nutritional guidance, medication optimization, education, and psychological support.

Associate Professor Michał Czapla from Wroclaw Medical University, one of the co-authors of the guidelines, stresses that rehabilitation is integral to a patient's care pathway, commencing during hospitalization and continuing in various settings, including rehabilitation centers, homes, or through telerehabilitation. This holistic intervention not only aims to restore physical fitness but also to enhance overall functioning, reduce the likelihood of future cardiovascular events, and improve quality of life and psychological well-being.

The guidelines underscore the importance of tailoring rehabilitation programs to each patient's unique health status, abilities, and individual needs. These programs encompass patient assessment, personalized physical activity, educational support, assistance in lifestyle changes, pharmacological treatment optimization, nutritional counseling, smoking cessation, and psychosocial care.

Furthermore, they address broader aspects like returning to work and sexual health, highlighting the multidisciplinary nature of cardiac rehabilitation, which involves collaboration among physicians, nurses, physiotherapists, dietitians, and psychologists.

Czapla emphasizes that the guidelines advocate for the integration of rehabilitation throughout a patient's care, not just as an add-on. Age, multimorbidity, or frailty should not deter a patient from participating in rehabilitation, but rather, programs should be adapted to ensure safety, improved functioning, and respect for the patient's individual capabilities.

This is particularly vital in the context of a growing number of patients with conditions such as heart failure, valvular heart disease, atrial fibrillation, and cardiomyopathies, as well as those with implanted cardiac devices or undergoing cancer treatments that could impact their cardiovascular health.

Despite its benefits, cardiac rehabilitation remains underutilized globally. The guidelines call for increased access to rehabilitation through various models, including home-based, telerehabilitation, and hybrid approaches, depending on the patient's clinical risk, needs, and circumstances. The goal is to ensure that all patients who could benefit from cardiac rehabilitation have the opportunity to participate, regardless of their age, frailty, or multimorbidity.