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News
The European Society of Cardiology has published its first-ever standalone cardiac rehabilitation guidelines, expanding indications beyond heart failure and acute coronary syndrome to include atrial fibrillation, valvular disease, and cardio-oncology. The guidelines push for earlier initiation of rehab — sometimes during hospitalization — and formally recognize telerehabilitation as a viable option. The goal: close the massive gap between who needs cardiac rehab and who actually gets it.
The European Society of Cardiology (ESC) has released its first dedicated cardiac rehabilitation guidelines, presented at ESC Congress 2026 in Munich and published simultaneously in the European Heart Journal. Previously scattered across disease-specific guidance documents, cardiac rehab now gets its own comprehensive, patient-centered framework — one that significantly broadens who qualifies and when they should start.
The new guidelines expand indications well beyond the traditional focus on acute coronary syndrome and heart failure to include atrial fibrillation, valvular heart disease, congenital heart disease, pulmonary arterial hypertension, and cardio-oncology. They also set clear timelines: rehab should begin within 14–30 days after an acute coronary syndrome and within 28–42 days after bypass surgery. For hospitalized heart failure patients, early initiation is recommended to reduce in-hospital mortality.
A major theme is tackling the persistent underuse of cardiac rehab. In France, for example, only 25% of acute coronary syndrome patients and as few as 5% of chronic coronary syndrome patients receive it. To bridge the gap, telerehabilitation receives a Class IIa recommendation — a first — particularly in hybrid models combining in-person and remote care.
Key Takeaways:
Why it matters: These guidelines could reshape how cardiac rehab is prescribed and delivered across Europe, pushing for standardization, earlier referral, and digital innovation — all aimed at getting more heart patients the recovery support they need.
