Cardiac rehabilitation outside cardiac rehabilitation centres, including light private rehabilitation structures and cardiac telerehabilitation

Dany Marcadet, Bruno Pavy, Sonia Corone, Antoine Faure, Marie Michelle Six, Ines Cazaubiel, Jean-Michel Guy, Frédéric Schnell

Despite strong recommendations, cardiac rehabilitation (CR) continues to be underused. In 2019, only 22.3% of patients who had an acute coronary syndrome underwent CR within 6 months of the event. Disparities persist between men (26%) and women (15%), with an average delay of 32 days, and there are significant regional variations (16% in Hauts-de-France compared with 30% in the Centre region, and even lower participation in overseas territories, e.g. 3.4% in Martinique). Data for other pathologies are unavailable [1]. Across Europe, rehabilitation rates after myocardial infarction range from < 25% in 17 countries to 25–50% in 14 countries, 50–75% in seven countries and 75–100% in four countries[2]. In the USA, 24% of eligible patients participate in rehabilitation (28.6% men, 18.9% women) [3]. French guidelines for CR have been updated, emphasizing its strong indications (Type I) for numerous conditions. However, limited accessibility to CR combined with shorter stays in acute cardiology units hamper the optimal initiation of secondary prevention [4]. Another reason for the low percentage of patients undergoing CR is the fact that the current healthcare offering does not adequately address patients’ concerns. Indeed, the barriers are numerous: fear of exercise and the hospital environment; lack of motivation; perceived lack of time; lack of prescriptions; family-related difficulties; socioprofessional responsibilities; and distant living arrangements [5]. This underutilization of CR requires reliable alternatives to rehabilitation in cardiac rehabilitation centres (CRCs) to be found, with the aim of better meeting patients’ needs and desires, while maintaining the same level of quality and safety.

• Cardiac rehabilitation

• Light private rehabilitation structures
• Cardiac telerehabilitation

1. Background
2. Current experiments
3. Telerehabilitation in the literature
4. Consensus on the management of CR outside specialized CRCs
5. Profile of patients eligible for these new CR modalities
6. Conclusions

© 2025 Elsevier Masson SAS. Tous droits réservés.