A virtual approach to healing the heart

If you've had a heart attack or other serious cardiovascular issue, cardiac rehabilitation is hands down the best way to prevent future heart problems. This program — which teaches the fundamentals of heart-healthy habits coupled with supervised exercise — normally takes place in person during hourlong sessions several times a week over the course of several months. Cardiac rehab is recommended for many conditions (see "Am I eligible for cardiac rehab?") and can reduce your risk of dying of heart disease by nearly 25%.

Unfortunately, only about 20% of people who qualify for cardiac rehab actually participate in these programs. One of the main reasons is the hassle of traveling to the sessions, even in urban areas. And for people who live in rural areas, where rehab centers are few and far between, attending multiple weekly sessions simply isn't feasible.

But a trend to move some (or even most) of cardiac rehab to a virtual delivery system has been ramping up over the past few years, says cardiologist Dr. Ami Bhatt, associate professor of medicine at Harvard Medical School and chief innovation officer for the American College of Cardiology. "The original concept of cardiac rehab — bringing people together to learn in a group setting — has many benefits," she says. Yes, it's an efficient way to teach people about nutrition and medication management. But groups also help people with shared experiences process the emotional aspects of coping with heart disease. Enabling people to connect remotely to the teaching and support sessions from home (using a computer, tablet, or smartphone) may also offer other advantages.

No place like home

Virtual cardiac rehab lets people avoid not only time and travel costs, but also the potential anxiety of having to return to the hospital or facility where they were treated for their heart problem, which upsets some people.

After a heart-related health scare, people often worry they'll have another heart problem, and these automatic negative thoughts can be quite debilitating. But stress and resiliency training delivered via videoconference can be incredibly helpful, says Dr. Bhatt, who recently co-authored a study showing the benefits of such training in adults who were born with heart disease.

Another key thing people learn about in cardiac rehab — how to improve their eating habits — might even be more instructive via a live video visit than conventional rehab, says Dr. Bhatt. When you're connected virtually, you can let the nutritionist or dietitian look around your kitchen and pantry to see what you're eating. "They might say, 'Hey, there's a low-salt version of that product that might be great for you,'" she says.

On-site exercise assessment

Of course, the initial cardiac rehab visit has be in person. It typically involves an assessment of your risks for heart disease and an exercise stress test, during which you exercise on a treadmill or stationary bike while being closely monitored. You'll get an individualized treatment plan with goals for your blood pressure, blood sugar, heart rate, and weight (and smoking cessation, if needed).

"It's comforting to have a nurse nearby assuring you that everything looks okay while you're exercising," Dr. Bhatt says. But after learning what intensity and amount of exercise is right for them, most people are fine to exercise on their own, either at home or at a gym. Some rehab programs even supply devices (such as heart rate monitors and blood pressure cuffs) for at-home monitoring.

Evidence and availability

So far, research suggests that virtual cardiac rehab compares favorably with conventional rehab in terms of keeping people out of the hospital and improving quality of life. A handful of companies have already created digital platforms to deliver virtual cardiac rehab and are partnering with large medical centers or major insurance companies. If you qualify for cardiac rehab, ask your cardiologist about virtual rehab, or if he or she would be willing to help you create some sort of blended program, says Dr. Bhatt.

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