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. 2025 Mar 4;6(3):508-518.
doi: 10.1093/ehjdh/ztaf014. eCollection 2025 May.

Feasibility, safety and patient perceptions of exercise-based cardiac telerehabilitation in a multicentre real-world setting after myocardial infarction-the remote exercise SWEDEHEART study

Maria Bäck  1   2   3 , Margret Leosdottir  4   5 , Mattias Ekström  6 , Kristina Hambraeus  7 , Annica Ravn-Fischer  2 , Sabina Borg  3 , Madeleine Brosved  1 , Marcus Flink  8 , Kajsa Hedin  9 , Charlotta Lans  10   11 , Jessica Olovsson  12   13 , Charlotte Urell  14 , Birgitta Öberg  3 , Stefan James  15   16
Affiliations

Feasibility, safety and patient perceptions of exercise-based cardiac telerehabilitation in a multicentre real-world setting after myocardial infarction-the remote exercise SWEDEHEART study

Maria Bäck et al. Eur Heart J Digit Health. .

Abstract

Aims: Cardiac telerehabilitation addresses common barriers for attendance at exercise-based cardiac rehabilitation (EBCR). Pragmatic real-world studies are however lacking, limiting generalizability of available evidence. We aimed to evaluate feasibility, safety, and patient perceptions of remotely delivered EBCR in a multicentre clinical practice setting after myocardial infarction (MI).

Methods and results: This study included 232 post-MI patients (63.7 years, 77.5% men) from 23 cardiac rehabilitation centres in Sweden (2020-22). Exercise was delivered twice per week for 3 months through a real-time group-based video meeting connecting a physiotherapist to patients exercising at home. Outcomes were assessed before and after remote EBCR completion and comprised assessment of physical fitness, self-reported physical activity and exercise, physical capacity, kinesiophobia, health-related quality of life (HRQoL), self-efficacy for exercise, exercise adherence, patient acceptance. Safety monitoring in terms of adverse events (AE) and serious adverse events (SAE) was recorded. A total of 67.2% of the patients attended ≥ 75% of prescribed exercise sessions. Significant improvements in physical fitness, self-reported exercise, physical capacity, kinesiophobia, and HRQoL were observed. Patients agreed that remote EBCR improved health care access (83%), was easy to use (94%) and found exercise performance and interaction acceptable (95%). Sixteen exercise-related AEs (most commonly dizziness and musculoskeletal symptoms) were registered, all of which were resolved. Two SAEs requiring hospitalization were reported, both unrelated to exercise.

Conclusion: This multicentre study supports remote EBCR post-MI as feasible and safe with a high patient acceptance in a real-world setting. The clinical effectiveness needs to be confirmed in a randomized controlled trial.

Trial registration number: NCT04260958.

Keywords: Cardiac rehabilitation; Coronary artery disease; Exercise; Secondary prevention; Telerehabilitation; eHealth.

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Conflict of interest statement

Conflict of interest: none declared.

Figures

Graphical Abstract
Graphical Abstract
Figure 1
Figure 1
PRISMA flow diagram of the screening process.
Figure 2
Figure 2
Patient perceptions of remote exercise-based cardiac rehabilitation.
See this image and copyright information in PMC

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