Cardiac Rehabilitation in Patients with Advanced Heart Failure

Cardiac rehabilitation (CR) remains an integral part of heart failure (HF) management, yet certain groups of patients with HF, particularly those with implantable devices, and those who are older and/or frail, are often precluded from CR. We performed a narrative review discussing the benefits of CR in these groups of patients, highlighting evidence from the existing literature. We further discuss special considerations for this patient group, including CR implementation for their long-term management. Hesitancy in referring vulnerable groups of patients with HF, specifically those with advanced HF, has led to poor outcomes in this patient cohort. However, we discuss the growing evidence supporting the use of CR, thus demonstrating the importance of HF services working closely with multi-disciplinary teams to better integrate CR into existing HF programs.