ESC Issues First Dedicated International Guidelines on Cardiac Rehabilitation
核心洞察
The European Society of Cardiology has published its first dedicated international guidelines on cardiac rehabilitation in the European Heart Journal, presented at ESC Congress 2026.
The guidelines consolidate evidence across multiple heart conditions, recommending rehabilitation beyond heart attack and heart failure (搜索) to include congenital heart disease (搜索), atrial fibrillation (搜索), and cancer patients with cardiac side effects.
Cardiac rehabilitation combines exercise training, emotional support, and personalized education delivered by multidisciplinary teams, with an individualized, shared decision-making approach.
The European Society of Cardiology (ESC) has published its first dedicated international guidelines on cardiac rehabilitation, released online today in the European Heart Journal and presented at ESC Congress 2026 on 31 August. The document marks a milestone in cardiovascular care by consolidating, for the first time, the best available evidence on cardiac rehabilitation across different heart conditions, rather than embedding recommendations within guidelines for specific situations such as heart attack or heart failure (搜索).
Cardiac rehabilitation is a personalized programme designed to help patients manage their cardiac disease and recover from a cardiac event or heart operation. Professor Maria Bäck, ESC Guidelines Task Force chair at Sahlgrenska University Hospital in Gothenburg, Sweden, described cardiac rehabilitation as "one of the most effective treatments in cardiovascular care, which provides positive effects beyond medication or surgery alone." Despite the growing number of people living with cardiovascular diseases, she noted that cardiac rehabilitation "is still underused across Europe and elsewhere."
The guidelines emphasize that cardiac rehabilitation extends well beyond cardiovascular recovery. Associate Professor Matthias Wilhelm, ESC Guidelines Task Force chair from Bern University Hospital in Switzerland, explained: "Although people are now living longer, these extra years are often lived in ill health, with poor physical and mental functioning." He added that improving rehabilitation is a key aim of the World Health Organization and is anchored in the EU Safe Heart Plan, and that a tailored programme "can not only improve heart health and reduce the risk of another cardiac event but can also improve general physical and mental wellbeing."
Delivered by a multidisciplinary team of specialists, an effective cardiac rehabilitation programme combines several core components, including exercise training, emotional support, and personalized education covering sustainable lifestyle changes and the importance of taking prescribed medications. Each patient's plan should be individualized to their needs, preferences, and personal circumstances, developed through shared decision-making between the patient and healthcare professionals.
The patient perspective played a central role in developing the guidelines, with patient representatives actively contributing to the task force. Professor Dominique Hansen, ESC Guidelines Task Force chair from Hasselt University in Belgium, observed: "One of the clearest messages from patients is that cardiac rehabilitation is about far more than physical recovery. Cardiac rehabilitation represents the journey back to everyday life after a major cardiac event. It helps patients regain confidence, independence, physical and mental wellbeing and trust in their bodies again." He added that it also provides families with knowledge, reassurance, and support during a highly stressful period.
Beyond established indications such as heart attack and heart failure (搜索), the guidelines highlight benefits for a wider range of patient groups. These include patients with congenital heart disease (搜索) or atrial fibrillation (搜索), those undergoing heart valve replacement, and patients with cancer who have received anticancer therapies associated with heart side effects.
A lack of reimbursement remains a barrier to access and implementation of cardiac rehabilitation in some countries, despite evidence consistently demonstrating that cardiac rehabilitation is cost-effective and often cost-saving due to reduced use of healthcare resources and fewer life-years spent in poor health. The guidelines highlight that, for selected patients, digitally enhanced home-based cardiac rehabilitation—incorporating remote monitoring and teleconsultations with healthcare professionals—can reduce healthcare costs and is more convenient compared with traditional hospital-based programmes.
The release of the 2026 ESC Guidelines on cardiac rehabilitation is timely, complementing existing recommendations in ESC Guidelines and other ESC scientific documents. A version of the guidelines is also available for patients.