AHA Scientific Sessions 2026 Abstract · Nov 2, 2026
Expanding Access and Improving Outcomes After Cardiac Surgery Utilizing Virtual Cardiac Rehabilitation
By Mack C, Gregg AC, Ingason A et al.
Background: Cardiac rehabilitation is an AHA/ACC/SCAI Class 1A recommendation shown to reduce mortality and readmission rates, while also improving patient quality of life following cardiac surgery. Despite these well-established benefits, cardiac rehabilitation remains an underutilized resource, with only approximately 20% of patients enrolling after cardiac surgery. Of those patients who enroll, upwards of 50% withdraw prior to completion. Research Question: This study sought to improve access and compliance with cardiac rehabilitation following cardiac surgery in an underserved population, via the utilization of a smartphone application (app) for delivery of virtual cardiac rehabilitation (VCR). Methods: We utilized a smartphone app and artificial intelligence (AI) to enhance patient engagement and compliance with VCR. VCR includes 36 sessions over 3 months with a certified licensed exercise physical therapist and supervision via a cardiologist specialized in cardiac rehabilitation. Patients are provided with wearable devices including pulse oximeter, mobile telemetry and blood pressure cuffs. Data from these devices are analyzed in real time using Bluetooth™. Sessions include guided exercise customized to the patient. Patients also received comprehensive education regarding medication compliance, nutrition and overall health maintenance, individualized to personal risk factors. One hundred consecutive patients were referred to this VCR program following cardiac surgery. Compliance with the rehabilitation program, 30- and 90-day readmissions and mortality were monitored. Results: Of the 100 consecutive patients referred to VCR, 93 enrolled (Figure 1). The median age of enrolled patients was 67.5 years [Interquartile Range (IQR) 55.8, 74.0)] and 41% (38/93) were female. Referrals were made upon discharge and up to 2 weeks following discharge. The median time from referral to enrollment was 3 days [IQR 2-6 days] compared to a national benchmark of 35 days for in-person rehabilitation. The median time from discharge to enrollment was 10 days [IQR 5-20 days] compared to a benchmark of 80 days (in-person rehabilitation). Enrolled patients attended 97% of the sessions scheduled (Figure 2). There were no 30- or 90-day readmissions or mortality over the duration of follow-up. Conclusion: This pilot study provides evidence that VCR may improve access to cardiac rehabilitation following discharge. The data also indicate that VCR may have the potential to improve enrollment and compliance when compared to in-person cardiac rehabilitation. Furthermore, a comprehensive VCR program that includes medication compliance, nutrition, outpatient follow-up and overall health maintenance may reduce postoperative mortality, decrease readmissions and improve quality of life, consistent with data from in-person cardiac rehabilitation.