ESC Guidelines Link Cardiac Rehab to Mental

The European Society of Cardiology (ESC) has published its first dedicated guidelines for cardiac rehabilitation. The document was released online in the European Heart Journal on August 30, 2026. It will be presented at the ESC Congress the following day.

Cardiac rehabilitation is a personalized program to help patients manage heart disease and recover from cardiac events or surgery. The new guidelines consolidate evidence across various heart conditions for the first time. They aim to highlight the treatment's broad benefits and provide practical implementation advice.

Professor Maria Bäck, ESC Guidelines Task Force chair from Sahlgrenska University Hospital in Sweden, called cardiac rehabilitation "one of the most effective treatments in cardiovascular care." She noted its positive effects extend beyond medication or surgery alone. Despite this, the therapy remains underused across Europe.

Core Components and Patient Focus

An effective program is delivered by a multidisciplinary team. It combines several core components. These include exercise training, emotional support, and personalized education on lifestyle changes and medication adherence.

Each patient's plan should be individualized. It must consider their needs, preferences, and personal circumstances. Development involves shared decision-making between the patient and healthcare professionals.

The patient perspective was central to creating the guidelines. Patient representatives actively contributed to the task force. Professor Dominique Hansen, another Task Force chair from Hasselt University in Belgium, explained the patient view.

"One of the clearest messages from patients is that cardiac rehabilitation is about far more than physical recovery," Hansen said. He described it as a journey back to everyday life that helps regain confidence, independence, and mental well-being. It also provides families with knowledge and support during a stressful period.

Broadening Eligibility and Delivery Methods

The guidelines recommend cardiac rehabilitation for patients after a heart attack and those with heart failure. They also highlight benefits for other groups. These include patients with congenital heart disease or atrial fibrillation, those who have undergone heart valve replacement, and cancer patients who received therapies with heart side effects.

A lack of reimbursement blocks access in some countries. This persists despite evidence showing cardiac rehabilitation is cost-effective and often cost-saving. Reduced healthcare use and fewer life-years spent in poor health drive the savings.

The guidelines note digitally enhanced home-based programs can reduce costs. These include remote monitoring and teleconsultations. They are often more convenient than traditional hospital-based programs.

Associate Professor Matthias Wilhelm, Task Force chair from Bern University Hospital, connected the guidelines to broader health goals. "Although people are now living longer, these extra years are often lived in ill health, with poor physical and mental functioning," he stated. Improving rehabilitation is a key aim of the World Health Organization and is anchored in the EU Safe Heart Plan.

A patient version of the ESC Guidelines on cardiac rehabilitation is also available.