The European Society of Cardiology (ESC) has published its first dedicated clinical practice guidelines on cardiac rehabilitation, calling for rehabilitation to be considered a core component of care across a broader range of cardiovascular conditions.
Published in the European Heart Journal on August 28 and presented at ESC Congress 2026 in Munich on August 31, the guidelines bring together recommendations that were previously spread across multiple disease-specific ESC guidelines.
Evidence reviewed by the Task Force indicates that cardiac rehabilitation in the post-acute and chronic care of heart disease can reduce hospitalizations while improving physical and mental functioning and quality of life.
Cardiac rehabilitation is more than exercise
A central message of the guidelines is that effective cardiac rehabilitation should extend beyond exercise training. The ESC describes it as a multicomponent intervention incorporating areas such as patient education, self-management and behavior change, optimization of cardiovascular therapies, physical activity and exercise, nutritional support, smoking cessation, and psychosocial management.
→ See our interview with Prof. Maria Bäck at ESC 2026, where we heard about the development and intended impact of the new guidelines.Â
The guidelines also broaden the range of patients who may benefit. In addition to established indications such as acute coronary syndromes and heart failure, cardiac rehabilitation may benefit selected patients following surgical or transcatheter aortic valve replacement, those with congenital heart disease or atrial fibrillation, and patients with cancer undergoing potentially cardiotoxic therapies.
Importantly, older age, frailty, and comorbidities should not in themselves be considered reasons to withhold cardiac rehabilitation. Instead, the guidelines emphasize comprehensive assessment and individualized, patient-centered programs based on medical, functional, psychosocial, and lifestyle needs.
The ESC also highlights more flexible approaches to delivery, with telehealth, telemedicine, and mobile health addressed within the guidelines. For selected patients, digitally enhanced home-based rehabilitation may provide a convenient and potentially cost-saving alternative or complement to traditional delivery models.
Despite its benefits, cardiac rehabilitation remains underused, with low referral and attendance rates in some countries. The ESC says improving implementation and participation will be increasingly important as the number of people living with chronic cardiovascular disease grows.
The guidelines were developed by a Task Force chaired by Professor Maria Bäck, Professor Dominique Hansen, and Associate Professor Matthias Wilhelm.
References
- Bäck M, Hansen D, Wilhelm M, et al. 2026 ESC Guidelines on cardiac rehabilitation. Eur Heart J. 2026. doi:10.1093/eurheartj/ehag099.
- European Society of Cardiology. Heart, body and mind – the first ESC Guidelines highlight the many benefits of cardiac rehabilitation. ESC Press Release. Published August 28, 2026.
Cite: ESC publishes first dedicated guidelines on cardiac rehabilitation touchCARDIO. September 9, 2026.
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Editor: Nicola Cartridge, Director of Content
touchCARDIO coverage of ESC Congress 2026: This content has been developed independently by Touch Medical Media for touchCARDIO. It is not affiliated with the ESC. Views expressed are the speaker’s own and do not necessarily reflect the views of Touch Medical Media.
