Cardiac rehabilitation

What is cardiac rehabilitation?

If you've recently had a heart attack, undergone heart surgery, or been told you have a condition such as heart failure, cardiac rehabilitation is a structured programme that combines exercise, education and support. It's built around your own circumstances, with the aim of getting you back on your feet and living life on your own terms again.

What conditions does cardiac rehabilitation treat?

Cardiac rehab can help after:

• a heart attack
• heart surgery, such as a bypass graft or valve repair or replacement
• a coronary angioplasty or having a stent fitted
• a diagnosis of heart failure
• stable angina
• other conditions, including cardiomyopathy, congenital heart disease, or having a device such as an ICD or ventricular assist device fitted.

What are the benefits of cardiac rehabilitation?

Taking part matters for your long-term health every bit as much as sticking with any medication you've been prescribed. It can help you:

• lower your chances of a further heart event, or of ending up back in hospital
• get a clearer picture of your condition and put lifestyle changes in place that support your heart, from better food choices to quitting smoking and moving more
• feel steadier in yourself, with knock-on benefits for your mental health and general wellbeing
• ease back into everyday life, work included.

Studies show that cardiac rehab can cut the risk of cardiovascular death by 58%, another heart attack by 30%, and stroke by 60%, alongside a 63% reduction in symptoms of depression. Finishing a programme has also been linked to added years of life expectancy.

Are there different ways to take part in cardiac rehabilitation?

There's no single format, and your team will help you find an approach that works for you:

• attending a class alongside others, such as at a hospital, community centre or leisure centre
• working through things from home, using videos, a written programme, an app or phone support
• a mixture of both.

Programmes are also generally organised into three stages: the first gets under way in hospital, the second consists of supervised outpatient sessions once you're discharged, and the third is about keeping up exercise independently over the longer term, sometimes through a community group.

What happens before cardiac rehabilitation?

You'll typically meet the cardiac rehab team for an initial conversation before your programme starts. This is your chance to explain what's important to you, raise any concerns, and settle on some goals together, both for the near term and further ahead.

• a physical examination and a look back through your medical history
• basic checks, such as an ECG, blood pressure, cholesterol and blood sugar
• a supervised exercise test, to see how your heart responds to activity
• a conversation about which risk factors, such as diet, smoking or activity levels, matter most to you
• agreeing your preferred format and a rough timeframe for the programme.

What happens during cardiac rehabilitation?

1. Each session opens with gentle movement, easing your body and heart into things before anything more demanding begins.
2. The main part of the session involves activity pitched at a level that suits you, which might be walking, cycling on a stationary bike, or light resistance work.
3. Someone keeps track of how you're managing throughout, often by checking your pulse or simply asking how the effort feels.
4. The session winds down gradually towards the end, easing your pulse and breathing back towards normal, sometimes finishing with a spot of relaxation.
5. Week by week, the demands of your exercise are increased a little at a time, in line with your progress and fitness.

What does recovery look like?

Cardiac rehab often begins before you've even left hospital, sometimes amounting to little beyond light movement, paired with an explanation of what's happened to you and what comes next.

Once you're home, supervised sessions generally pick up somewhere in the following month or so, held weekly or twice weekly for a couple of months, so the whole stretch often lands somewhere close to three months in total.

When the structured part comes to an end, many people keep going unaided, or move into ongoing sessions run by community groups, sometimes for a long stretch afterwards.

What are the risks and complications?

Cardiac rehab is supervised throughout by trained staff, and complications are uncommon. On rare occasions, exercise might trigger an injury or an irregular heartbeat. Should either happen, staff will pause your exercise and treat you immediately, and may check in with your cardiologist or GP before letting you carry on with the programme.