Effectiveness of Remote Cardiac Rehabilitation: A Meta-Analysis

ABSTRACT

Background Cardiac rehabilitation (CR) is a Class 1 indication for patients following acute coronary syndrome, coronary intervention and in patients with chronic, stable heart failure. However, rates of participation remain abysmal. Following the COVID-19 pandemic, interest in remote cardiac rehabilitation (R-CR) has increased. Efficacy of R-CR versus the current standard of care remains unclear. Methods A systematic review of the available literature was performed according to the PRISMA 2020 checklist. Of the identified studies, further screening was done to isolate randomized controlled trials (RCT) that measured objective markers of physical fitness such as peak oxygen consumption during exercise (VO2 max) and distance traveled during 6 minute walk test (6MWT). Results 20 RCTs were identified that compared R-CR versus either standard CR or usual care that did not include a component of CR. There is no difference in the change in exercise capacity achieved based on whether a patient underwent R-CR versus standard CR. There was a significant difference in the change in exercise capacity achieved in patients who underwent R-CR versus usual care. R-CR is associated with a significant change in VO2 max but not distance walked on 6MWT. Conclusion R-CR is not inferior to standard CR in improving VO2 max and distance walked on 6MWT. R-CR may be superior to usual care that does not include an element of CR. This is potentially beneficial as increased adoption of R-CR may improve participation in CR as a whole. [Formula presented]Copyright © 2023 American College of Cardiology Foundation