Secondary prevention through comprehensive cardiovascular rehabilitation: From knowledge to implementation. 2020 update. A position paper from the Secondary Prevention and Rehabilitation Section of the European Association of Preventive Cardiology

Author:

Ambrosetti Marco1,Abreu Ana2,Corrà Ugo3,Davos Constantinos H4,Hansen Dominique5,Frederix Ines6,Iliou Marie C7,Pedretti Roberto F E8,Schmid Jean-Paul9,Vigorito Carlo10,Voller Heinz11,Wilhelm Matthias12,Piepoli Massimo F13,Bjarnason-Wehrens Birna14,Berger Thomas15,Cohen-Solal Alain16,Cornelissen Veronique17,Dendale Paul18,Doehner Wolfram1920,Gaita Dan21,Gevaert Andreas B1822,Kemps Hareld23,Kraenkel Nicolle2425,Laukkanen Jari26,Mendes Miguel27,Niebauer Josef28,Simonenko Maria29,Zwisler Ann-Dorthe Olsen30

Affiliation:

1. Department of Cardiac Rehabilitation, ICS Maugeri Care and Research Institute, Italy

2. Serviço de Cardiologia, Hospital Universitário de Santa Maria/Centro Hospitalar Universitário Lisboa Norte (CHULN), Centro Académico de Medicina de Lisboa (CAML), Centro Cardiovascular da Universidade de Lisboa (CCUL), Faculdade de Medicina, Universidade de Lisboa, Portugal

3. Department of Cardiac  Rehabilitation, ICS Maugeri Care and Research Institute, Italy

4. Cardiovascular Research Laboratory, Biomedical Research Foundation, Academy of Athens, Greece

5. REVAL and BIOMED-Rehabilitation Research Centre, Hasselt University, Belgium

6. Department of Cardiology, Jessa Hospital, Belgium

7. Department of Cardiac Rehabilitation and Secondary Prevention, Hôpital Corentin Celton, Assistance Publique Hopitaux de Paris Centre-Universite de Paris, France

8. Cardiology Department, IRCCS Multimedica, Italy

9. Department of Cardiology, Clinic Barmelweid, Switzerland

10. University of Naples Federico II, Italy

11. Klinik am See, Rehabilitation Centre for Internal Medicine, Rüdersdorf and Centre of Rehabilitation Medicine, University Potsdam, Germany

12. Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Switzerland

13. Heart Failure Unit, G. da Saliceto Hospital, AUSL Piacenza and University of Parma, Italy

14. Department of Preventive and Rehabilitative Sport Medicine and Exercise Physiology, Institute for Cardiology and Sports Medicine, German Sport University Cologne, Germany

15. St. John of God’s Hospital Linz, Austria

16. Cardiology Department, Hopital Lariboisiere, Paris University, France

17. Cardiovascular Exercise Physiology Group, KU Leuven, Belgium

18. Heart Centre, Jessa Hospital Campus Virga Jesse, Belgium

19. Department of Cardiology (Virchow Klinikum), German Centre for Cardiovascular Research (DZHK), Germany

20. BCRT – Berlin Institute of Health Centre for Regenerative Therapies, and Centre for Stroke Research Berlin, Charité Universitätsmedizin Berlin, Germany

21. University of Medicine & Pharmacy ‘Victor Babes’ Cardiovascular Prevention & Rehabilitation Clinic, Romania

22. Research group Cardiovascular Diseases, GENCOR Department, University of Antwerp, Belgium

23. Department of Cardiology, Maxima Medical Centre, The Netherlands

24. Charité – University Medicine Berlin, Germany

25. German Centre for Cardiovascular Research (DZHK), Germany

26. Central Finland Health Care District Hospital District, Finland

27. Cardiology Department, CHLO-Hospital de Santa Cruz, Portugal

28. University Institute of Sports Medicine, Prevention and Rehabilitation, Paracelsus Medical University, Austria

29. Physiology Research and Blood Circulation Department, Cardiopulmonary Exercise Test SRL, Heart Transplantation Outpatient Department, Federal State Budgetary Institution, ‘V.A. Almazov National Medical Research Centre’ of the Ministry of Health of the Russian Federation, Russian Federation

30. REHPA–Danish Knowledge Centre for Rehabilitation and Palliative Care, University of Southern Denmark, Odense University Hospital, Denmark

Abstract

Abstract Secondary prevention through comprehensive cardiac rehabilitation has been recognized as the most cost-effective intervention to ensure favourable outcomes across a wide spectrum of cardiovascular disease, reducing cardiovascular mortality, morbidity and disability, and to increase quality of life. The delivery of a comprehensive and ‘modern’ cardiac rehabilitation programme is mandatory both in the residential and the out-patient setting to ensure expected outcomes. The present position paper aims to update the practical recommendations on the core components and goals of cardiac rehabilitation intervention in different cardiovascular conditions, in order to assist the whole cardiac rehabilitation staff in the design and development of the programmes, and to support healthcare providers, insurers, policy makers and patients in the recognition of the positive nature of cardiac rehabilitation. Starting from the previous position paper published in 2010, this updated document maintains a disease-oriented approach, presenting both well-established and more controversial aspects. Particularly for implementation of the exercise programme, advances in different training modalities were added and new challenging populations were considered. A general table applicable to all cardiovascular conditions and specific tables for each clinical condition have been created for routine practice.

Publisher

Oxford University Press (OUP)

Subject

Cardiology and Cardiovascular Medicine,Epidemiology

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