First ESC Clinical Guideline for Cardiac Rehabilitation | ESC 2026، 28 Aug, 2026
First ESC Clinical Guideline for Cardiac Rehabilitation | ESC 2026، 28 Aug, 2026
* First-ever ESC dedicated clinical guideline for cardiovascular rehabilitation.
* Cardiac rehabilitation is no longer viewed as simply an exercise program; it is a comprehensive, multidisciplinary intervention.
* Applies broadly across cardiovascular disease: CAD/MI, heart failure, valve disease, arrhythmias, congenital heart disease, and patients with cardiovascular effects of cancer therapy.
* Rehabilitation should be personalized according to clinical risk, patient needs, preferences, functional status, and individual goals.
* Delivery can be center-based, home-based, or hybrid—the model should fit the patient rather than requiring one fixed approach.
* Frailty and comorbidities should not automatically exclude patients from cardiac rehabilitation.
* Core components extend beyond exercise to include optimization of medical therapy, risk-factor control, nutrition, physical activity, psychological support, and patient education/self-management.
* A major goal is long-term secondary prevention: patients should learn to recognize warning symptoms, manage medications, monitor their condition, and maintain healthy behaviors.
* Introduces the concept of “better in, better out”—optimizing health and risk factors before planned cardiac interventions may help prepare patients for recovery.
* Psychological rehabilitation is emphasized, including addressing fear of recurrent cardiac events and helping patients regain confidence and independence.
* Important evidence gaps remain, including cost-effectiveness and optimal programs for rehabilitation in some cardiomyopathies.
* ACC perspective: Richard Kovacs described the new ESC guideline as “eye-opening”; currently there is no comparable comprehensive ACC/AHA cardiac rehabilitation guideline.
Key message: Cardiac rehabilitation should become an integral part of cardiovascular treatment—not an optional service after the acute event.