Cardiac rehabilitation after MI

Which patients after myocardial infarction (MI) qualify for cardiac rehabilitation? When should it be started and what should it involve?

Gerd Hasenfuß, MD: That is a difficult question because not so much data are available. I am in favor of rehabilitation after MI in general. I think it is particularly important in patients who have heart failure due to MI or after MI. It should be started immediately after hospital discharge, maybe after 1 week or so.

It is important in rehabilitation that you train the patients to do exercises. They have to learn how they can do exercises and what training options exist. But they also need an educational program with respect to risk factors, smoking cessation, drug treatment, body weight control, nutrition, and so forth. I think it is very important.

I would ask the question, “How do you do it?” It can be done in a rehabilitation clinic, but there is also evidence that it can be home-based. That depends on the patient. It is an individual decision. In the future, we also may have some sort of tailored rehabilitation.