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Home-based mobile guided cardiac rehabilitation is safe and effective in elderly patients with coronary heart disease or valvular interventions


The international, multicenter, randomized ER-CaRE trial aiming to assess safety and efficacy of a 6-month guided mobile cardiac rehabilitation (MCR) program in elderly patients who decline participation in conventional cardiac rehabilitation was published online in JAMA Cardiology on October 28, 2020. A total of 179 elderly patients with coronary heart disease or after surgical or percutaneous valvular interventions were enrolled (81% men, median age, 72 years). The duration of follow-up was 12 months. Patients in the MCR group were offered a 6-month home-based cardiac rehabilitation program in which they were equipped with a smartphone and heart rate belt. Patients were instructed to exercise at moderate intensity for at least 30 minutes per day, 5 days per week. Patients in the control group did not receive any form of cardiac rehabilitation but received locally defined standard of care. Peak oxygen uptake improved in the MCR group (n = 89) at 6 and 12 months (1.6 [95% CI, 0.9-2.4] mL/kg−1/min−1 and 1.2 [95% CI, 0.4-2.0] mL/kg−1/min−1, respectively), whereas there was no improvement in the control group (n = 90) (+0.2 [95% CI, −0.4 to 0.8] mL/kg−1/min−1 and +0.1 [95% CI, −0.5 to 0.7] mL/kg−1/min−1, respectively). Changes in Vo2peak were greater in the MCR vs control groups at 6 months (+1.2 [95% CI, 0.2 to 2.1] mL/kg−1/min−1) and 12 months (+0.9 [95% CI, 0.05 to 1.8] mL/kg−1/min−1). The incidence serious adverse events was low and did not differ between the MCR and control groups (13% vs 11%, р = 0.66).