COVID-19 Pandemic: Wake-up Call and Accelerator for Cardiac Rehabilitation

Cardiac rehabilitation (CR) is a cornerstone of secondary prevention in cardiovascular care, improving survival, reducing rehospitalization, and enhancing quality of life. Despite robust evidence and strong guideline support, CR remains markedly underutilized in Canada and globally, with significant disparities by sex, race, geography, and socioeconomic status. The COVID-19 pandemic disrupted more than three-quarters of CR programs worldwide, exposing deep-rooted limitations in access, infrastructure, and delivery models. At the same time, the pandemic served as a catalyst for innovation. Rapid implementation of virtual, home-based, and hybrid models demonstrated that CR could be delivered flexibly and effectively beyond traditional settings. This review synthesizes emerging evidence and policy responses, highlighting opportunities to modernize CR delivery while embedding equity, patient-centeredness, and digital innovation into routine care. We conclude that the future of CR must be inclusive, technology-enabled, and integrated into the broader continuum of preventive care. The lessons of the pandemic offer a roadmap-and a renewed imperative-to close longstanding gaps and reimagine cardiac rehabilitation for all who need it.