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Overview of Cardiac Rehabilitation: The Patient

For whom is Cardiac Rehabilitation (CR) indicated?

Which categories of patients?

A majority of patients after acute myocardial infarction (AMI), percutaneous coronary intervention (PCI) or cardiac surgery are offered CR (high referral rates in countries such as France, Belgium and Bosnia and Herzegovina) but CR services to heart failure patients are severely underused across Europe, although there are some good practices (FranceBelgium, Italy)

Ways of referral:

Patients are usually referred following a cardiologist assessment from either the discharging cardiac hospital, hospital-based clinics, community cardiologists or primary care physicians. France seems to be the only member that adapted standardized referral by an automatic software. France’s strategy accounted for a referral rate of 36% after AMI, 60-70 % after cardiac surgery, and 9 % after a first hospitalisation for Heart Failure. Bosnia and Herzegovina claimed that 60% of patients after an AMI, PCI or cardiac surgery are being referred down the line. Belgium reported that 78% of patients aged < 80 years who were hospitalized for a coronary event were advised to follow CR.

Referral rate:

The general referral rates vary strongly across Europe (figure 1).

Figure 1. Cardiac rehabilitation mean referal according to indication (if reported)


The general uptake rates vary strongly across Europe (figure 2).

Figure 2. Cardiac rehabilitation mean uptake according to indication (if reported)


Note: The content of this article reflects the personal opinion of the author/s and is not necessarily the official position of the European Society of Cardiology.


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This first version is derived from 28 "Country of the Month" reports from National CVD Prevention Coordinators of ESC member countries. Additional countries will be incorporated in the next version.