Hybrid cardiac rehabilitation as an Optimal Strategy for Post-MI Recovery: A 14-Week Prospective Study on Clinical and Functional Outcomes (Preprint)

BACKGROUND Hybrid cardiac rehabilitation (CR) combining supervised and home-based phases with wearable monitoring may improve access and outcomes after myocardial infarction (MI). OBJECTIVE To assess the impact of a 14-week hybrid CR program on functional class, exercise capacity, hemodynamics, body composition, and physical activity in post-MI patients with NYHA class II symptoms. METHODS Sixty-six adults post-MI underwent 2 weeks of in-hospital initiation followed by 12 weeks of home-based rehabilitation via a smartwatch-smartphone platform. Within-subject changes from baseline to week 14 were analyzed using appropriate paired statistical tests. RESULTS NYHA class improved significantly, with 39% of participants downgrading their class (p<0.001). Body weight decreased by 1.27±2.51 kg (p<0.001). Systolic and diastolic blood pressures declined (both p≤0.002). Maximal METS rose markedly (25.7% increase; p<0.001), and watts/kg improved (p<0.001). Resting heart rate decreased (p=0.002); peak exercise heart rate change was non-significant. Fat mass declined and skeletal muscle mass increased (mean gain 0.98 kg; p<0.001). Daily step count increased from 5,550±2,026 to 7,267±2,500 steps (p<0.001). Total body water also increased (p<0.001). CONCLUSIONS The hybrid CR program produced significant improvements in functional class, exercise capacity, blood pressure, body composition, and physical activity in post-MI NYHA II patients, supporting its effectiveness as a remotely enabled secondary prevention strategy.