The iATTEND Trial: A Trial Comparing Hybrid Versus Standard Cardiac Rehabilitation

Area of Science:

• Cardiology
• Rehabilitation Medicine
• Digital Health

Background:

• Cardiac rehabilitation (CR) traditionally relies on facility-based sessions.
• Improving patient attendance and adherence to CR programs remains a challenge.
• Hybrid CR (HYCR) models combining virtual and in-facility sessions are emerging.

Purpose of the Study:

• To compare attendance rates between hybrid CR (HYCR) and traditional facility-based CR (FBCR).
• To assess the equivalence of improvements in exercise capacity and health status between HYCR and FBCR.
• To evaluate the safety of HYCR.

Main Methods:

• The iATTEND trial randomized 282 patients to either HYCR or FBCR.
• Attendance was measured by the number of CR sessions completed within 6 months.
• Exercise capacity (peak oxygen uptake, 6-minute walk distance) and health status were assessed for equivalence.

Main Results:

• No significant difference in the total number of CR sessions completed within 6 months between HYCR (29 ± 12) and FBCR (28 ± 12).
• Equivalence in improvements in exercise capacity and self-reported health status was demonstrated between the groups.
• HYCR was found to be safe, with no major adverse events directly attributable to the virtual sessions.

Conclusions:

• Hybrid CR (HYCR) does not yield greater attendance than traditional facility-based CR (FBCR).
• HYCR provides equivalent improvements in exercise capacity and health status compared to FBCR.
• Virtually supervised exercise within a hybrid CR model is an acceptable alternative to facility-based CR.