According to findings shared at ESC Congress 2026, incorporating remotely delivered cardiac rehabilitation alongside centre-based initiatives yielded an equivalent count of completed sessions compared to utilizing centre-based programmes exclusively. Professor Maria Bäck from Sahlgrenska University Hospital and University of Gothenburg reported that while remote video sessions successfully expanded patient access at home, overall population-level completion rates remained largely unchanged at roughly 14%.
Remote Exercise SWEDEHEART Trial Design and Findings
The Remote Exercise SWEDEHEART study evaluated 3,112 patients between the ages of 18 and 79 with type 1 MI across 23 Swedish centres, according to registry data shared at the congress. During 15-month intervention periods, clinics offered patients remotely delivered exercise, centre-based exercise or a combination of both. During control periods, patients were offered centre-based exercise only. Researchers tracked a mean age of around 67 years, with women making up approximately one-quarter of participants, as noted in the study metrics.
The percentage of individuals who finished the entire exercise regimen proved remarkably comparable across settings: 13.8% during the intervention timeframe and 13.6% throughout the control phase. However, when remote exercise was accessible, patients actively utilized it. Approximately 38% of recorded exercise sessions were performed remotely, while approximately 62% were performed at a centre, according to trial metrics. Following the completion of the exercise programme, physical capacity showed improvement in both cohorts, displaying no statistically significant variance between them.
Safety and Adverse Event Rates in Home-Based Training
Active safety monitoring throughout the trial revealed low rates of serious, exercise-related adverse events in both delivery models. Findings reported from the research indicated that serious adverse events linked to exercise occurred at a frequency of 0.47 instances per 1,000 patient-hours for centre-based physical activity and 0.17 instances per 1,000 patient-hours for remotely conducted exercise. Both remote and centre-based exercise followed the same principles of individually prescribed aerobic and resistance training, with progression based on clinical assessment and established cardiac rehabilitation guidelines.
Physical capacity outcomes remain equivalent when aerobic and resistance training principles are closely followed under physiotherapist supervision.
Addressing Persistent Barriers to Cardiac Rehabilitation Uptake
Despite exercise-based cardiac rehabilitation being strongly recommended for patients after a myocardial infarction (MI) in the ESC Guidelines on acute coronary syndromes and in the new ESC Guidelines on cardiac rehabilitation, overall participation remains low. Professor Bäck pointed out that supervised centre-based exercise programmes are successfully finished by just a minority of qualified patients—roughly 15%—both domestically in Sweden and across the wider European region. The trial results indicate that remote delivery fails to solve low overall participation on its own, pointing toward deeper systemic hurdles.
Professor Bäck explained that barriers extending beyond travel logistics continue to suppress uptake. These obstacles include other co-existing diseases, language barriers, socioeconomic factors and varying levels of digital health literacy. As a result, the investigators deduced that remote exercise-based cardiac recovery programmes ought to be treated as a complementary, patient-centric alternative instead of a substitute for centre-based care or an independent fix for low engagement rates.
Frequently Asked Questions
Q: What was the primary finding of the Remote Exercise SWEDEHEART study?
A: Adding remotely delivered exercise to centre-based programmes resulted in a similar number of completed sessions as centre-based programmes only, achieving completion rates of 13.8% and 13.6% respectively, according to study results presented at ESC Congress 2026.
Q: How was the remote cardiac rehabilitation delivered?
A: Home-based remote cardiac rehabilitation utilized synchronized video group sessions, enabling patients to complete workouts from their residences while a hospital-based physiotherapist directed and monitored the training, adhering to standard aerobic and resistance exercise guidelines.
Q: Is remote cardiac rehabilitation safe for post-MI patients?
A: Safety records from the clinical trial revealed that serious complications tied to physical activity were rare, showing that such adverse events occurred at a frequency of 0.47 per 1,000 patient-hours during centre-based workouts and 0.17 per 1,000 patient-hours during remotely executed training sessions.
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