[Initial experiences with a comprehensive ambulatory rehabilitation program for heart patients]

213 patients (197 males and 16 females, mean age 58.5 years) have taken part during the first 5 years in our comprehensive outpatient cardiac rehabilitation program (101 patients after acute myocardial infarction, 73 patients after heart surgery and 39 patients with various cardiac problems). The program consists of three elements: (1.) regular physical training in an outpatient group three times a week for 6-12 weeks; (2.) information and education of the patient and if possible of the family about risk factors and life-style changes, and (3.) psychosocial support. During 10,838 hours of active rehabilitation, no life-threatening complication occurred. After completion of the program, 73% of the patients were fully rehabilitated (return to work in the active working population, reintegration in the family and daily life in the retired and non-working patients), 15% of the patients interrupted the program because of further invasive treatment, and in 11% the goal of the rehabilitation program was not achieved. Follow-up was carried out by a questionnaire 3-56 months (mean 25 months) later. The percentage of smokers decreased from 55% before the program to 18% (p < 0.05), regular physical exercise increased from 49% to 76% (p < 0.05), and the perceived stress level of high intensity decreased from 53 to 9% (p < 0.05). Our findings indicate that a comprehensive cardiac rehabilitation program in an outpatient setting in conjunction with a community hospital is feasible; it can be conducted with a high degree of safety and is followed by considerable lifestyle changes.