Standardised Exercise Prescription for Patients with Chronic Coronary Syndrome and/or Heart Failure: A Consensus Statement from the EXPERT Working Group.

Whereas exercise training, as part of multidisciplinary rehabilitation, is a key component in the management of patients with chronic coronary syndrome (CCS) and/or congestive heart failure (CHF), physicians and exercise professionals disagree among themselves on the type and characteristics of the exercise to be prescribed to these patients, and the exercise prescriptions are not consistent with the international guidelines. This impacts the efficacy and quality of the intervention of rehabilitation. To overcome these barriers, a digital training and decision support system [i.

[The ECG in cardiac rehabilitation].

The concept and the benefits of cardiac rehabilitation are well established and scientifically proven. In the context of shortened in-hospital stays and older patients receiving more complex interventions, complications of those procedures might occur during cardiac rehabilitation. This article discusses guideline-directed diagnosis and treatment of complications after transcatheter aortic valve replacement, especially delayed-onset heart block, post-operative atrial fibrillation, and acute coronary ischemia in the setting of pre-existent bundle branch block.

Cardiac Rehabilitation in German Speaking Countries of Europe-Evidence-Based Guidelines from Germany, Austria and Switzerland LLKardReha-DACH-Part 1.

Background: Although cardiovascular rehabilitation (CR) is well accepted in general, CR-attendance and delivery still considerably vary between the European countries. Moreover, clinical and prognostic effects of CR are not well established for a variety of cardiovascular diseases.

Methods: The guidelines address all aspects of CR including indications, contents and delivery.

Comprehensive multicomponent cardiac rehabilitation in cardiac implantable electronic devices recipients: a consensus document from the European Association of Preventive Cardiology (EAPC; Secondary prevention and rehabilitation section) and European Heart Rhythm Association (EHRA).

Cardiac rehabilitation (CR) is a multidisciplinary intervention including patient assessment and medical actions to promote stabilization, management of cardiovascular risk factors, vocational support, psychosocial management, physical activity counselling, and prescription of exercise training. Millions of people with cardiac implantable electronic devices live in Europe and their numbers are progressively increasing, therefore, large subsets of patients admitted in CR facilities have a cardiac implantable electronic device. Patients who are cardiac implantable electronic devices recipients are considered eligible for a CR programme.

Patient-reported outcomes predict return to work and health-related quality of life six months after cardiac rehabilitation: Results from a German multi-centre registry (OutCaRe).

Background: Multi-component cardiac rehabilitation (CR) is performed to achieve an improved prognosis, superior health-related quality of life (HRQL) and occupational resumption through the management of cardiovascular risk factors, as well as improvement of physical performance and patients' subjective health. Out of a multitude of variables gathered at CR admission and discharge, we aimed to identify predictors of returning to work (RTW) and HRQL 6 months after CR.

Design: Prospective observational multi-centre study, enrolment in CR between 05/2017 and 05/2018.

Geriatric or cardiac rehabilitation? Predictors of treatment pathways in advanced age patients after transcatheter aortic valve implantation.

Background: Aim of the study was to find predictors of allocating patients after transcatheter aortic valve implantation (TAVI) to geriatric (GR) or cardiac rehabilitation (CR) and describe this new patient group based on a differentiated characterization.

Methods: From 10/2013 to 07/2015, 344 patients with an elective TAVI were consecutively enrolled in this prospective multicentric cohort study. Before intervention, sociodemographic parameters, echocardiographic data, comorbidities, 6-min walk distance (6MWD), quality of life and frailty (score indexing activities of daily living [ADL], cognition, nutrition and mobility) were documented.

Patients' expectations of returning to work, co-morbid disorders and work capacity at discharge from cardiac rehabilitation.

Objective: We aimed to characterize patients after an acute cardiac event regarding their negative expectations around returning to work and the impact on work capacity upon discharge from cardiac rehabilitation (CR).

Methods: We analyzed routine data of 884 patients (52±7 years, 76% men) who attended 3 weeks of inpatient CR after an acute coronary syndrome (ACS) or cardiac surgery between October 2013 and March 2015. The primary outcome was their status determining their capacity to work (fit vs unfit) at discharge from CR.

No impact of an extensive social intervention program on return to work and quality of life after acute cardiac event: a cluster-randomized trial in patients with negative occupational prognosis.

Objectives: To examine the effectiveness of extensive social therapy intervention during inpatient multi-component cardiac rehabilitation (CR) on return to work and quality of life in patients with low probability of work resumption after an acute cardiac event.

Methods: Patients after acute cardiac event with negative subjective expectations about return to work or unemployment (n = 354) were included and randomized in clusters of 3-6 study participants. Clusters were randomized for social counseling and therapy led by a social worker, six sessions of 60 min each in 3 weeks, or control group (usual care: individual counseling meeting by request).

Determinants of Return to Work After Multicomponent Cardiac Rehabilitation.

Objectives: To explore predictors of return to work in patients after acute coronary syndrome and coronary artery bypass grafting, taking into account cognitive performance, depression, physical capacity, and self-assessment of the occupational prognosis.

Design: Observational, prospective, bicentric.

Setting: Postacute 3-week inpatient cardiac rehabilitation (CR).

The importance of return to work: How to achieve optimal reintegration in ACS patients.

The vocational reintegration of patients after an acute coronary syndrome is a crucial step towards complete convalescence from the social as well as the individual point of view. Return to work rates are determined by medical parameters such as left ventricular function, residual ischaemia and heart rhythm stability, as well as by occupational requirement profile such as blue or white collar work, night shifts and the ability to commute (which is, in part, determined by physical fitness). Psychosocial factors including depression, self-perceived health situation and pre-existing cognitive impairment determine the reintegration rate to a significant extent.

Impact of cognitive performance on disease-related knowledge six months after multi-component rehabilitation in patients after an acute cardiac event.

Background: Although associations between cardiovascular diseases and cognitive impairment are well known, the impact of cognitive performance on the success of patient education as a core component of cardiac rehabilitation remains insufficiently investigated so far.

Design: Prospective observational study in two inpatient cardiac rehabilitation centres between September 2014 and August 2015 with a follow-up six months after cardiac rehabilitation.

Method: At admission to and discharge from cardiac rehabilitation, the cognitive performance of 401 patients (54.

Exercise Prescription in Patients with Different Combinations of Cardiovascular Disease Risk Factors: A Consensus Statement from the EXPERT Working Group.

Whereas exercise training is key in the management of patients with cardiovascular disease (CVD) risk (obesity, diabetes, dyslipidaemia, hypertension), clinicians experience difficulties in how to optimally prescribe exercise in patients with different CVD risk factors. Therefore, a consensus statement for state-of-the-art exercise prescription in patients with combinations of CVD risk factors as integrated into a digital training and decision support system (the EXercise Prescription in Everyday practice & Rehabilitative Training (EXPERT) tool) needed to be established. EXPERT working group members systematically reviewed the literature for meta-analyses, systematic reviews and/or clinical studies addressing exercise prescriptions in specific CVD risk factors and formulated exercise recommendations (exercise training intensity, frequency, volume and type, session and programme duration) and exercise safety precautions, for obesity, arterial hypertension, type 1 and 2 diabetes, and dyslipidaemia.

[Quality Performance Measures in Cardiac Rehabilitation - Results of a Delphi Survey of Members of the German Society for Prevention and Rehabilitation of Cardiovascular Diseases (DGPR)].

Objective: The present investigation aimed an explorative acquisition of potential performance measures for quantifying the quality of cardiac rehabilitation (CR) for patients under 65 years of age.

Methods: A 4-level web based Delphi survey of physicians, psychologists, and sports or physiotherapists in CR was conducted from April to July in 2016. The experts assessed several parameters of physical performance, social medicine, subjective health and cardiovascular risk factors regarding their suitability as performance measures of CR.

[Regional Aspects in Treatment of Patients with Acute Myocardial Infarction in the North-East of Germany].

Background:  In recent decades, guideline-based therapy of myocardial infarction has led to a considerable reduction in myocardial infarction mortality. However, there are relevant differences in acute care and the extent of infarction mortality. The objective of this survey was to analyze the current care situation of patients with acute myocardial infarction in the region of northeast Germany (Berlin, Brandenburg and Mecklenburg-Vorpommern).

Return to work in heart failure patients with suspected viral myocarditis.

Background: Endomyocardial biopsy is considered as the gold standard in patients with suspected myocarditis. We aimed to evaluate the impact of bioptic findings on prediction of successful return to work.

Methods: In 1153 patients (48.

Nutrition and mobility predict all-cause mortality in patients 12 months after transcatheter aortic valve implantation.

Background: The aim of the study was to determine pre-interventional predictors for all-cause mortality in patients after transcatheter aortic valve implantation (TAVI) with a 12-month follow-up.

Methods: From 10/2013 to 07/2015, 344 patients (80.9 ± 5.

Improvement of left ventricular ejection fraction in revascularized postmyocardial patients: indication for statistical fallacy.

Background: Reduced left ventricular ejection fraction (LVEF) ≤30% is the most powerful prognostic indicator for sudden cardiac death (SCD) in patients after myocardial infarction (MI), but there are little data about long-term changes of LVEF after revascularization and the following implantation of a cardioverter defibrillator (ICD).

Methods: We performed a retrospective analysis of 277 patients with reduced LVEF at least 1 month after MI and complete revascularization. Patients (median time post-MI 23.

Uromodulin associates with cardiorenal function in patients with hypertension and cardiovascular disease.

Objective: Common genetic variants in the gene encoding uromodulin (UMOD) have been associated with renal function, blood pressure (BP) and hypertension. We investigated the associations between an important single nucleotide polymorphism (SNP) in UMOD, that is rs12917707-G>T, and estimated glomerular filtration rate (eGFR), BP and cardiac organ damage as determined by echocardiography in patients with arterial hypertension.

Methods: A cohort of 1218 treated high-risk patients (mean age 58.

[Return to Work after Acute Myocardial Infarction].

Vocational reintegration provides a key goal for patients after myocardial infarction both from social as well as from individual perspective. Return to work rate is determined by medical parameters such as left ventricular function, residual ischemia and rhythm stability, as well as by occupational requirement profile such as the blue or white collar work, night shifts and the way capacity. Psycho-social factors including depression, self-assessment of their own situation and pre-existing cognitive impairment to a large extent determine the reintegration.

User Interest in Digital Health Technologies to Encourage Physical Activity: Results of a Survey in Students and Staff of a German University.

Background: Although the benefits for health of physical activity (PA) are well documented, the majority of the population is unable to implement present recommendations into daily routine. Mobile health (mHealth) apps could help increase the level of PA. However, this is contingent on the interest of potential users.