Meta-analysis finds remote cardiac rehabilitation matches or exceeds centre-based care for heart failure patients

A systematic review and meta-analysis in JMIR mHealth and uHealth pooled eight randomised controlled trials (1,368 patients) comparing mobile-health-supported remote, virtual or hybrid cardiac rehabilitation against usual care or centre-based cardiac rehabilitation in patients with heart failure, most with reduced ejection fraction [Meta-analysis]. Against centre-based rehabilitation, the remote/hybrid model showed a statistically significant greater improvement in peak oxygen uptake, though this was based on a limited number of trials; against usual care, it was associated with improved six-minute walk distance. Certainty of evidence ranged from low to moderate throughout.

The authors are explicit that superiority, equivalence or non-inferiority against centre-based rehabilitation cannot be concluded from the current evidence, given the small number of trials in that specific comparison. No intervention-related deaths or serious adverse events were reported, but sparse events and short follow-up limit what can be concluded about safety.

For heart failure services facing centre-based cardiac rehabilitation capacity constraints, this supports remote or hybrid delivery as a credible option for some patients, though the evidence does not yet support it as a wholesale replacement for centre-based rehabilitation, and longer-term safety data remain limited.