Remote cardiac rehabilitation in patients with heart failure: A prospective study

Background:
Cardiac rehabilitation plays a pivotal role in managing patients with heart failure with reduced ejection fraction [HfrEF], improving prognosis and exercise tolerance. However, utilization remains low globally, with less than 20% of eligible patients participating, largely due to the limited capacity of center-based programs. Remote cardiac rehabilitation has emerged as a potential solution, though its efficacy and safety in HFrEF patients remain untested. This study aimed to evaluate the feasibility, safety, and efficacy of remote cardiac rehabilitation in patients with HFrEF.

Methods:
This prospective study plans to enrol 50 participants with HFrEF. Inclusion criteria include left ventricular ejection fraction (LVEF) ≤ 35%, NYHA Class II-III, and ICD implantation. Exercise capacity was assessed by treadmill stress tests measuring metabolic equivalents (METs). Primary endpoints were defined as improvements of ≥ 10% and ≥ 25% in exercise capacity at 3 and 6 months.

Results:
To date, 21 patients with a mean LVEF of 28% ± 7.89 have been enrolled. Of these, 12 patients completed the 3-month follow-up. After 3 months of remote rehabilitation, the mean exercise capacity increased from 5.9 ± 1.19 METs to 6.2 ± 1.32 METs, with 4 participants (33%) achieving a ≥ 10% improvement in exercise capacity. Mean weight decreased from 85 ± 13.57 kg at baseline to 82.7 ± 14.49 kg at 3 months, with 5 participants showing a weight reduction of ≥ 2 kg.

Conclusion:
Our preliminary results suggest that remote cardiac rehabilitation is a feasible and effective strategy for patients with HFrEF, demonstrating measurable improvements in exercise capacity and weight reduction.