Remote Exercise SWEDEHEARTHot Line 5Digital Health
Cardiac Telerehabilitation in Type 1 Myocardial Infarction: A Cluster Randomized Cross-Over Trial
Cardiac telerehabilitation: a cluster randomised cross-over trial
Presenting authorMaria BäckGeneral / Preventive / Lipids · Sahlgrenska University HospitalMaria Bäck is an adjunct professor of physiotherapy at Linköping University and a licensed physiotherapist at the exercise-based cardiac rehabilitation unit of Sahlgrenska University Hospital in Gothenburg, Sweden. She holds a PhD from the University of Gothenburg (2012) and is a Fellow of the European Society of Cardiology. Her research focuses on physical activity, exercise-based cardiac rehabilitation, telerehabilitation, and secondary prevention in patients with cardiovascular disease.
Key result
Offering remotely delivered exercise alongside centre-based options did not significantly increase the proportion of patients completing the full rehabilitation programme (13.8% vs 13.6%).
Overview
Awaiting ESC 2026 results before adopting telerehabilitation; RCT will extend evidence on remote cardiac rehabilitation access.
Discussion
Remote Exercise SWEDEHEART has reported — post the first read.
Expert takes
Sentiment overview
The Remote Exercise SWEDEHEART study is a multicenter registry-based cluster randomized crossover trial evaluating whether remotely delivered exercise-based cardiac rehabilitation (EBCR), offered as an alternative to center-based EBCR, can increase participation among myocardial infarction patients. Despite strong evidence for exercise-based cardiac rehabilitation, only about 20% of MI patients in Sweden complete such programs.
Maria Bäck
Specialist physiotherapist, Sahlgrenska University Hospital
“Enligt det svenska kvalitetsregistret SWEDEHEART är det bara ca 20% av patienter med hjärtinfarkt som genomför ett fysioterapeutlett träningsprogram inom hjärtrehabilitering. Frågan är om det ens hade accepterats om motsvarande låga siffra hade uppmätts för till exempel förhöjda blodtryck?”
TG
Tomasz Guzik
Chair, ESC Congress Program Committee
“This year, ESC Congress received a record number of submissions of late-breaking clinical trials, reflecting the remarkable pace of innovation across cardiology. We rigorously selected the studies with the greatest scientific quality and potential clinical impact.”
T
Trialsgram
Expert commentary
“VIRTUES — In 1,963 patients with an ICD or pacemaker, remote-only device management via an e-health platform was non-inferior to scheduled in-clinic follow-up for major adverse cardiac events at 18 months. https://t.co/vFWrQf3q0D @escardio #ESCCongress #ESC2026 #EBM https://t.co/04Qf15TrjW”
Key Points
- To evaluate whether adding remote home-exercise options to cardiac rehabilitation increases session completion and physical capacity compared to centre-based training alone in patients following a myocardial infarction.
- Registry-based, cluster-randomised crossover trial conducted across 23 centres in Sweden among patients aged 18–79 years with type 1 myocardial infarction.
- Centres alternated between 15-month intervention periods (offering remotely delivered exercise, centre-based exercise, or both based on patient preference) and control periods (centre-based exercise only).
- Full programme completion was 13.8% during intervention periods compared with 13.6% during control periods, with no statistically significant increase in the mean number of completed exercise sessions.
- When remote sessions were available, approximately 38% of recorded sessions were completed remotely and 62% at a centre.
- Physical capacity improved in both the intervention and control groups, with no significant difference observed between groups.
Study Design
Type
RCT
Randomization
Cluster-randomized crossover
Multicenter
Yes
Structured PICO
Does offering remotely delivered exercise increase the mean number of completed exercise sessions in patients with type 1 myocardial infarction?
P
Population
Patients aged 18-79 years with type 1 myocardial infarction across 23 Swedish centres.
I
Intervention
Remotely delivered exercise, centre-based exercise, or both according to patient preference during 15-month intervention periods
C
Comparator
Centre-based exercise only during control periods
O
Outcome
Mean number of completed exercise sessions
Offering a remote option for cardiac rehabilitation did not increase overall participation or completion rates compared to center-based exercise alone in post-myocardial infarction patients.
Main Result
Absolute Event Rate: 13.8% vs 13.6%