Selecting a Cardiac Rehabilitation Program for Heart Health

A heart attack is a scary, life-changing event. You want to think that, once it's over, it's over, and you won't have to worry about dealing with heart trouble again. However, nobody is simply able to forget about what happened, jump out of bed, and get back to normal. Before you start up your old routines, you'll need to go through a cardiac rehabilitation program that will help you learn to live a heart-healthier life.

According to Denise Gimbel, RN, MPH, "Cardiac rehabilitation is 'after care' to help clients with a recent cardiac event or diagnosis to get safely back to their activities of daily living, exercise, work etc." Gimbel is a cardiopulmonary rehab coordinator at French Hospital Medical Center.

Gimbel states that referral to a cardiac rehab program is "highly recommended for patients with a recent heart attack, stent or angioplasty, heart surgery, stable angina, and/or certain types of heart failure." The length of the program is determined by your specific recovery goals and your home exercise setup.

What to Expect

A cardiac rehabilitation program is divided into three phases.

• Phase I occurs while you are still in the hospital. You'll begin to walk and move around on your own. You'll also start receiving education about heart health and risk factors. At the end of this phase, you'll enroll at an outpatient cardiac rehabilitation center for Phase II.
• Phase II lasts for up to 36 sessions. You'll get more education and engage in monitored exercise. Gimbel explains that, "Equipment includes treadmills, bikes (upright and recumbent), seated steppers, arm ergometers, and free weights." You'll work with your cardiac rehabilitation team, which includes nurses and exercise therapists. Your team may also include a registered dietitian, certified diabetes educator, or a medical social worker.
• Phase III happens at home. You'll transition to home exercise while maintaining the fitness and dietary mandates from the first two phases.

You'll exercise in a gym where your heart rate and rhythm, blood pressure, and exertion levels can be observed by medical staff. A comprehensive cardiac rehab program also includes education on heart-related risk factors, lifestyle-modification classes, diet instruction, and emotional-support programs customized to your needs. The National Institutes of Health (NIH) reports that many program attendees have experienced fewer hospital admissions and a decreased risk of developing future heart-related issues. According to Gimbel, "The American College of Cardiology and CMS (Medicare) agree that participation in cardiac rehabilitation can reduce complications, improve healing, and actually decrease death rate."

Your Specific Program

You and the staff will create your recovery goals together. You may focus on getting back to work, increasing your exercise levels, or losing weight to reduce the risk of another attack. According to Gimbel, "Sessions are tailored to the individual, taking into account their previous activity level, physical limitations, and exercise preferences. Our goal is to move toward 30 minutes of moderate aerobic exercise most days of the week, with muscle strengthening exercises two days a week."

What Program Is Right for You?

When you're ready to enroll in a cardiac rehab program, you may find out that you have a lot of options. You and your doctor should consider the following:

• Referral: Because cardiac rehab is a medically supervised program, a doctor's referral is required. Your doctor will be notified of any changes in your treatment plan or if anything happens that requires medical attention. You'll also receive reports on your progress to take to your medical appointments.
• Place and setting: The program you choose may be in a hospital or an outpatient facility. Make certain that you can get to your program easily via personal or public transportation.
• Cost: The initial phases of cardiac rehab are often covered by your health insurance, but later phases are generally covered by you. Check with your health insurance company regarding cardiac rehab programs within your insurance plan.
• Emergency preparedness and supervision: There should always be a supervising doctor available on site during exercise sessions, and emergency procedures should be available for your review. Make sure that you are comfortable with these procedures before you commit to a program.

The right cardiac program can make a big difference to your recovery and how easily you can get back to your life. Ask your doctor if a cardiac rehab program is the right course of action to help you improve your health and prevent future heart problems.