Bringing cardiac rehabilitation into the new decade

During the 10 years since the European Association of Preventive Cardiology (EAPC) published its first position paper on cardiac rehabilitation,¹ there has been greater recognition of its integral role in the management of patients with various cardiac conditions. Cardiology has also witnessed significant leaps forward in therapies and identified new patient populations requiring tailored rehabilitation interventions.

Against this background, Doctor Marco Ambrosetti (Istituti Clinici Scientifici Maugeri IRCCS, Pavia, Italy), first author of a new 2020 position paper update, describes the aims of the latest version.² “Firstly, we wanted to make sure that recommendations echoed the very latest scientific information in the literature. But, more than that, we wanted to bring the publication into line with the Appraisal of Guidelines for Research and Evaluation (AGREE II) tool,³ which ensures that recommendations are of the highest quality,” he says.

Publications identified in an electronic database search were evaluated and graded in a collaborative effort involving the authors of the original paper and current EAPC Secondary Prevention and Rehabilitation Section members. “One of the strengths of the paper is the large number of authors and reviewers involved, 28 in total,” observes Dr. Ambrosetti, “and, because these cardiac rehabilitation specialists come from many different countries, the statement really reflects the European position as well as local differences.”

The group made a conscious decision to minimise the amount of text and to present data in tables, so that the statement remains a practical and user-friendly tool for the cardiovascular rehabilitation community. In an effort to keep the recommendations current, the next update has already been planned for release in 2026.

According to Dr. Ambrosetti, some of the key highlights readers can expect in the latest paper are the comprehensive update of the traditional core components of cardiac rehabilitation and advice on the management of new challenging populations, such as frail patients, those with cardiac implantable electronic devices and cancer patients. Implementation of exercise programmes and advances in different training modalities, as well as actions to improve patient adherence, are also addressed.

1. Piepoli MF, et al. Eur J Cardiovasc Prev Rehabil 2010;17:1–17.
2. Ambrosetti M, et al. Eur J Cardiovasc Prev Rehabil 2020; accepted for publication.
3. Brouwers MC, et al. CMAJ 2010;182:E839–842.