Heart failure can bring on many symptoms — shortness of breath, fatigue, swelling — that makes getting through the day hard to handle. After a diagnosis, it’s important to adjust your exercise, diet, and other lifestyle habits to promote heart health. That can be tough to do on your own. To help you get on track, your doctor may recommend a program known as cardiac rehabilitation, or cardiac rehab for short.
Cardiac rehab is a personalized program for people who have heart failure that’s run by a team of healthcare professionals. “Exercise training is the first, and most important, component of rehab,” says Tina Shah, MD, a cardiologist at Kaiser Permanente in Seattle.
Of course, more physical activity may be the last thing on your mind. Or, like others with heart failure, you may even be afraid of exerting yourself, notes Dr. Shah. “[People] may think, How can you put me through rigorous exercise when I’ve just been diagnosed with a heart condition?“
But, a medically supervised exercise program is just what people with heart failure need, and that’s not all you’ll get out of cardiac rehab. These programs also teach you about nutrition, healthier choices, and how to manage your medications, says Shah.
Read on to learn the ins and outs of cardiac rehab programs — and what to expect if your doctor recommends one for you.
Benefits of Cardiac Rehab
According to Shah, cardiac rehab can help you with heart failure by:
- Improving your ability to exercise, as well as your stamina and strength
- Boosting your quality of life by increasing your ability and energy to go about your day
- Lowering your risk of hospitalization and death from heart failure
- Enhancing your overall psychological and social well-being by reducing stress and improving your mood
Even though the goal is to create an individualized plan, cardiac rehab is often provided in a group setting. So, it’s an opportunity to connect with others who are going through a similar experience and support each other along the way.
Despite all of these advantages, not very many people use this type of program. In fact, less than 10 percent of adults who have heart failure go to cardiac rehab, according to the American Heart Association. Part of the reason for that is simply being unaware. Many people with heart disease — and even some doctors — don’t know that cardiac rehab is available for heart failure.
What Types of Providers Are on a Cardiac Rehab Team?
A cardiac rehab team typically includes a variety of healthcare professionals, who each play a unique role:
- Cardiologist Oversees your medical management, provides guidance on medications, and monitors your progress
- Nurses Monitor vital signs and provide education, counseling, and support on such topics as self-care, medication management, symptom recognition, and quitting certain behaviors, such as smoking
- Exercise physiologist Develops an individualized exercise program after testing your fitness level and then supervises your progress
- Dietitian Evaluates your nutritional needs, develops personalized meal plans, and teaches you the importance of following a heart-healthy diet
And sometimes:
- Behavioral health specialist Provides support for psychological and emotional challenges, such as anxiety, depression, and stress
What to Expect During Cardiac Rehab
Cardiac rehab treatment programs usually last 12 weeks, and people typically go three times a week, for a total of 36 sessions. If you can’t do three sessions a week, you may be able to do two sessions a week and spread the treatment out for a few more weeks.
Sessions last about an hour. That time is typically broken out into:
- 5–10 minutes to warm up
- 30–45 minutes of exercise
- 5–10 minutes to cool down
According to Dr. Raymond, exercise time is generally spent rotating through exercise machines. For example, you might do 10 minutes on a treadmill and then 10 to 15 minutes on a bike or elliptical. If this type of equipment is too much at first, you might be able to work out on a recumbent stepper, which lets you sit in a more horizontal position, giving you a lower-impact workout that’s easier on your body.
If you’re concerned about committing to a full rehab program, consider signing up for two to four weeks to start, Raymond advises. That way, “The data from monitoring can provide a lot of insight on how you’re doing — if you could exercise a little bit more or if this amount is too much — and where we need to go from there.”
Virtual Rehab and Remote Monitoring
People usually go to a hospital or cardiac rehab center, but you might find it difficult to get to a rehab center two or three times a week, because you’re unable to drive or can’t find someone to give you a ride, particularly if the hospital or rehab center is far away.
Luckily, virtual at-home rehab programs and remote monitoring devices have become more available. “We have technology that people can use to transmit data to their cardiac rehab team, so they can let us know, ‘I did 10,000 steps today. I did resistance training,’” says Shah. Ask your doctor if this technology is available to you.
Does Insurance Pay for Cardiac Rehab?
Medicare and most insurance companies will pay for cardiac rehab for people who have been out of the hospital for at least six weeks and have an ejection fraction below 35 percent. (Ejection fraction is the way doctors measure your heart’s ability to pump blood, with the lower end of normal being at least 50%. The lower the percentage, the more serious the heart failure.)
Copays can be steep, though — as much as $50–$100 per session. If rehab isn’t covered by your insurance, more limited, less expensive rehab programs are available at some centers, notes Raymond.
What’s Next After Cardiac Rehab?
After you complete the cardiac rehab program, your team will check your exercise capacity. “They’ll show you, ‘Wow, look at where you started and look at where you are now!’” says Shah. “There’s usually an amazing improvement in performance and symptoms.”
This can inspire you to stick to your exercise program, healthier eating, and self-care plan. That’s the goal of cardiac rehabilitation. It’s a way to transition you into a new phase of the program where you continue these healthy habits and, with your doctor’s help, manage your heart failure so you get more out of life.
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