Feasibility of hybrid cardiac telerehabilitation within the managed care after acute myocardial infarction program: insights from the multicenter polish MC-AMI-TELEREHAB Registry
E Piotrowicz, K Piotrowicz, P Orzechowski, A Wlochacz, M Kurpaska, K Szymczak, A Mawlichanow, R Zaluska, T Derewiecki, D Szalewska, M Kurpesa, A Kubica, I Kowalik, B Szafran, R PiotrowiczAbstract
Background
The Managed Care after Acute Myocardial Infarction (MC-AMI) program, providing one year of coordinated post-infarction care, was launched in Poland. Hybrid cardiac telerehabilitation (TELEREHAB) is one of its key and innovative components.
Purpose
The objective of the MC-AMI-TELEREHAB registry was to evaluate the implementation of TELEREHAB within the MC-AMI framework and to assess its feasibility, safety, and patient adherence.
Methods
All centers in Poland offering TELEREHAB within the MC-AMI program from 2022 to 2025 were invited to participate in the registry. The TELEREHAB program consisted of 3–5 educational on-site training sessions and 24 telemonitored home-based exercise sessions (one session per day, two to five times per week), including endurance training (walking, Nordic walking, or cycle ergometer), resistance and respiratory exercises, combined with pro-health behavior education and consultations with a dietitian and a psychologist. Each training session was telemonitored using a device capable of ECG recording and data transmission via mobile phone to a central monitoring center. The impact on physical capacity was evaluated by comparing exercise test duration and functional capacity at the beginning and at the end of TELEREHAB.
Results
Ten centers participated in the MC-AMI-TELEREHAB registry, enrolling 580 patients with a mean age of 60.2 ± 9.9 years; 79.5% were men (n = 461), after AMI (NSTEMI - 56.3%; STEMI - 43.7%), with a mean LVEF of 52.25 ± 8.5%. TELEREHAB led to a significant improvement in physical capacity (Table). No deaths or major adverse events occurred during the program. The drop-out rate from TELEREHAB was 3.3% (n = 19).
Conclusion
Hybrid cardiac telerehabilitation delivered as part of the MC-AMI program is a feasible and safe form of rehabilitation, with high patient adherence.