Indian Expert Consensus on Hybrid Cardiac Rehabilitation in the Management of Cardiovascular Disease

Cardiac rehabilitation (CR) is a structured, multidisciplinary, supervised program designed for patients recovering from cardiovascular (CV) events. This consensus aims to establish expert recommendations regarding hybrid CR (HCR) in the management of cardiovascular disease (CVD) in India. The objective was to review the existing literature and develop Indian expert opinions on HCR for CVD management. A comprehensive review of the current literature on HCR was conducted by experts. Based on the evidence gathered, the experts confirmed 10 statements regarding the management of CVD using HCR. These statements were presented at a conference booth, during a conference, where responses were collected from cardiac experts. The statements were graded based on the level of evidence: Level A evidence, indicating strong evidence from randomized controlled trials (RCTs) or meta-analyses; Level B, moderate evidence from RCTs with surrogate measures, observational studies, or meta-analyses; and Level C, weak evidence from observational studies, surrogate measures, or expert opinion. Of these 10 statements, six received Level A evidence, two received Level B evidence, and the remaining two received Level C. Feedback was documented, and the statements were finalized into a consensus. The consensus emphasizes the importance of acceptance, duration, monitoring, medication adherence, and the structure of HCR, as well as the roles of the CR team and the outcomes of HCR for patients with CVD. HCR is reported to enhance patients' adherence to medication, exercise, and diet, improve quality of life, and reduce the risk of CVD. Thus, the study successfully developed an expert consensus on HCR, offering valuable insights for its future integration into CR practices in India.