Cardiac rehabilitation for heart failure: 'Cinderella' or evidence-based pillar of care?

Cardiac rehabilitation remains the 'Cinderella' of treatments for heart failure. This state-of-the-art review provides a contemporary update on the evidence base, clinical guidance, and status of cardiac rehabilitation delivery for patients with heart failure. Given that cardiac rehabilitation participation results in important improvements in patient outcomes, including health-related quality of life, this review argues that an exercise-based rehabilitation is a key pillar of heart failure management alongside drug and medical device provision. To drive future improvements in access and uptake, health services should offer heart failure patients a choice of evidence-based modes of rehabilitation delivery, including home, supported by digital technology, alongside traditional centre-based programmes (or combinations of modes, 'hybrid') and according to stage of disease and patient preference.
Competing Interests: Conflict of interest None of the authors have any conflict of interest or relationships with industry that could have influenced this manuscript. R.S.T., H.D., and A.D.Z. are active cardiac rehabilitation researchers that include systematic reviews/meta-analyses and clinical trials of cardiac rehabilitation in patients with heart failure. The authors declare that all illustrations and figures in the manuscript are entirely original and do not require reprint permission.
(© The Author(s) 2023. Published by Oxford University Press on behalf of the European Society of Cardiology.)