Heart, body and mind – the first ESC Guidelines highlight the many benefits of cardiac rehabilitation

Key takeaways

• The first dedicated ESC Guidelines on cardiac rehabilitation have been published today in the European Heart Journal.
• The new guidelines highlight how cardiac rehabilitation can improve quality of life, physical fitness, confidence and mental wellbeing, while reducing the risk of future heart problems.
• Despite being highly effective, cardiac rehabilitation remains underused in many countries.

Munich, Germany - 28 August 2026: The European Society of Cardiology (ESC) Guidelines on cardiac rehabilitation have been published online today in the European Heart Journal.[1] The new guidelines will be presented at ESC Congress 2026 on 31 August.[2]

Cardiac rehabilitation is a personalised programme designed to help patients to manage their cardiac disease and to recover from a cardiac event or from a heart operation. Until now, recommendations on cardiac rehabilitation have been included in ESC Guidelines related to specific situations, such as after a heart attack and in patients with heart failure. For the first time, international experts have brought together the best available evidence on cardiac rehabilitation across different heart conditions. They have compiled a comprehensive document on its benefits, optimal components, modes of delivery and implementation, and the patients for whom it should be recommended.

"Cardiac rehabilitation is one of the most effective treatments in cardiovascular care, which provides positive effects beyond medication or surgery alone," said ESC Guidelines Task Force chair, Professor Maria Bäck from Sahlgrenska University Hospital, Gothenburg, Sweden. "Despite the growing number of people living with cardiovascular diseases, cardiac rehabilitation is still underused across Europe and elsewhere. The new guidelines provide the opportunity to highlight the benefits of cardiac rehabilitation and also include practical information on how it should be implemented, which is lacking in some guidelines focused on specific conditions."

ESC Guidelines Task Force chair, Associate Professor Matthias Wilhelm from Bern University Hospital, Bern, Switzerland, added: "Although people are now living longer, these extra years are often lived in ill health, with poor physical and mental functioning. For this reason, improving rehabilitation is a key aim of the World Health Organization [3] and is anchored in the EU Safe Heart Plan.[4] The new ESC Guidelines describe how a tailored programme of cardiac rehabilitation can not only improve heart health and reduce the risk of another cardiac event but can also improve general physical and mental wellbeing."

Delivered by a multidisciplinary team of specialists, an effective cardiac rehabilitation programme combines several core components, including exercise training, emotional support and personalised education covering aspects including how to achieve sustainable lifestyle changes and the importance of taking prescribed medications. Each patient's cardiac rehabilitation plan should be individualised to their needs, preferences and personal circumstances, and developed through shared decision-making between the patient and healthcare professionals.

The patient perspective has been central in developing the guidelines, with patient representatives actively contributing to the task force. ESC Guidelines Task Force chair, Professor Dominique Hansen from Hasselt University, Hasselt, Belgium, noted: "One of the clearest messages from patients is that cardiac rehabilitation is about far more than physical recovery. Cardiac rehabilitation represents the journey back to everyday life after a major cardiac event. It helps patients regain confidence, independence, physical and mental wellbeing and trust in their bodies again. At the same time, it provides families with knowledge, reassurance and support during a highly stressful period."

In addition to recommending cardiac rehabilitation after a heart attack and heart failure, the guidelines highlight that there are benefits for other patients, such as those with congenital heart disease or atrial fibrillation, after heart valve replacement and in patients with cancer who have received anticancer therapies associated with heart side effects.

A lack of reimbursement is a barrier to access and implementation of cardiac rehabilitation in some countries. This is despite evidence consistently demonstrating that cardiac rehabilitation is cost-effective and often cost-saving due to reduced use of healthcare resources and fewer life-years spent in poor health. The guidelines highlight that for selected patients, digitally enhanced home-based cardiac rehabilitation − which includes remote monitoring and teleconsultations with healthcare professionals - can reduce healthcare costs and is more convenient compared with traditional hospital-based programmes.

In this dynamic and much-needed area of cardiology, the release of the 2026 ESC Guidelines on cardiac rehabilitation is timely, complementing existing recommendations in ESC Guidelines and other ESC scientific documents. A version of the ESC Guidelines on cardiac rehabilitation is also available for patients.[5]

ENDS