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

by European Society of Cardiology

edited by Swati Mestri, reviewed by Andrew Zinin

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The European Society of Cardiology (ESC) Guidelines on cardiac rehabilitation have been published online today in the European Heart Journal. The new guidelines will be presented at ESC Congress 2026 on Aug. 31.

Cardiac rehabilitation is a personalized program designed to help patients manage their cardiac disease and recover from a cardiac event or 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, providing 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 and is anchored in the EU Safe Heart Plan.

The new ESC Guidelines describe how a tailored program of cardiac rehabilitation can not only improve heart health and reduce the risk of another cardiac event but also improve general physical and mental well-being."

Delivered by a multidisciplinary team of specialists, an effective cardiac rehabilitation program combines several core components, including exercise training, emotional support and personalized education covering how to achieve sustainable lifestyle changes and the importance of taking prescribed medications.

Each patient's cardiac rehabilitation plan should be individualized to their needs, preferences and personal circumstances and developed through shared decision-making between the patient and health care 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 well-being 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 benefits for other patients, such as those with congenital heart disease or atrial fibrillation, those who have undergone heart valve replacement and 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 because of reduced use of health care 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 health care professionals—can reduce health care costs and is more convenient than traditional hospital-based programs.

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.

Journal information: European Heart Journal

Key medical concepts

Cardiac RehabilitationHeart Failure

Clinical categories

CardiologyHealthy livingFitness & Physical activityPsychology & Mental health Provided by European Society of Cardiology Who's behind this story?

Swati Mestri

Swati Mestri holds a bachelor's degree in Electronics Engineering and has worked as a content editor since 2019. She has experience editing research documents across technology, health care, and materials science, and has a particular interest in technology and space. Full profile →

Andrew Zinin

Master's in physics with research experience. Long-time science news enthusiast. Plays key role in Science X's editorial success. Full profile →

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