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KMID : 0614720160590120938
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Journal of Korean Medical Association
2016 Volume.59 No. 12 p.938 ~ p.946
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Overview of cardiac rehabilitation
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Kim Chul
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Abstract
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Cardiac rehabilitation (CR) is an integral component of the continuum of care for patients with cardiovascular disease. Today, the efficacy and safety of CR are well established, but the rate of participation in CR is only at 20% to 40% in patients who actually need CR. CR restores a patient's exercise capacity, brings emotional stability, and helps a patient to effectively control risk factors of cardiovascular diseases. In addition, CR decreases recurrence, re-hospitalization, and reintervention, as well as mortality. CR is indicated for myocardial infarction, percutaneous coronary intervention, bypass graft surgery, and cardiac valve surgery, but also for advanced heart failure, pacemaker implantation, left ventricular assistive device implantation, and transplantation surgery. The core components of CR (designed to lead the patient to reach target levels) are patient evaluation, dietary treatment, weight management, blood pressure management, blood lipid management, diabetes management, smoking cessation, psycho-social management, physical activity counseling, and exercise training. In order for exercise training to be safely conducted, the risk stratification for exercise-related cardiovascular complications must be evaluated and high risk patients should exercise under supervision, including electrocardiogram monitoring. Given the low participation rate of eligible patients in hospital-based CR, alternative approaches using smart phones or mobile electrocardiogram devices instead of the traditional supervised intervention can be applied in low-risk patients. The ultimate goal is to implement appropriate CR programs in all patients who need CR to help them effectively manage cardiovascular risk factors and lead healthy lives.
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KEYWORD
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Cardiac rehabilitation, Cardiovascular diseases, Exercise, Secondary prevention
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