ESC Issues First Dedicated Guidelines on Cardiac Rehabilitation

The European Society of Cardiology (ESC) has published its first dedicated guidelines on cardiac rehabilitation, bringing together recommendations that had previously been scattered across separate guidelines for specific conditions such as heart attack and heart failure. The guidelines were published online in the European Heart Journal and will be presented at the ESC Congress 2026 on August 31.

Cardiac rehabilitation is a personalized program designed to help patients manage cardiac disease and recover from a cardiac event or heart operation. For the first time, international experts have compiled a single comprehensive document covering its benefits, optimal components, modes of delivery, implementation, and which patients should be offered it.

"Cardiac rehabilitation is one of the most effective treatments in cardiovascular care, providing positive effects beyond medication or surgery alone," said ESC Guidelines Task Force chair Prof. Maria Bäck of Sahlgrenska University Hospital in Gothenburg, Sweden. "Despite the growing number of people living with cardiovascular diseases, cardiac rehabilitation is still underused across Europe and elsewhere."

An effective program combines several components delivered by a multidisciplinary team, including exercise training, emotional support, and personalized education on sustainable lifestyle changes and the importance of taking prescribed medications. Each patient's plan is meant to be individualized to their needs and developed through shared decision-making with their healthcare team.

Beyond heart attack and heart failure, the guidelines recommend cardiac rehabilitation for patients with congenital heart disease or atrial fibrillation, those who have had heart valve replacement, and cancer patients who received treatments associated with heart side effects. For selected patients, the guidelines note that digitally enhanced home-based rehabilitation — including remote monitoring and teleconsultations — can be more convenient than hospital-based programs and can reduce healthcare costs.

The guidelines also note that a lack of reimbursement remains a barrier to access in some countries, even though evidence shows cardiac rehabilitation is cost-effective and often cost-saving overall, because it reduces the use of healthcare resources and the number of life-years spent in poor health.