[Cardiac Rehabilitation]

Physical training, psychosocial intervention, nutrition counselling and optimisation of secondary preventive medication to reduce morbidity and mortality of the disease as well as the reintegration into social life and return to work are equivalent goals of cardiac rehabilitation. This requires multifactorial intervention by a multidisciplinary team. In Germany, cardiac rehabilitation starting early after an index event could demonstrate a significant reduction of total mortality, myocardial infarction and hospitalisation during a follow-up of 1-2 years in 5 controlled cohort studies including 12 556 patients after myocardial infarction and CABG surgery. The reduction of clinical events was obtained in addition to rapid revascularisation therapy during the acute coronary event and on top of evidence based medication. In national and international guidelines, cardiac rehabilitation is recommended as well after valve surgery or intervention, in patients with heart failure and after ICD-, CRT- and VAD-implantation. Cardiac rehabilitation in Germany should be evaluated in a randomised controlled trial as well. In addition, multifactorial interventions should be tailored individually to specific patient subgroups, medical conditions and comorbidities. Return to work should be emphasized as a major topic of cardiac rehabilitation.