The benefits of cardiac rehabilitation programmes for people with heart failure have been well established. They have been proven to “reduce cardiovascular mortality, reduce hospital admissions, improve exercise capacity and health-related quality of life.” (Scottish Collegiate Guidelines Network 2017).
“I see patients diagnosed with heart failure hugely benefit from cardiac rehabilitation – not only physical improvement, but psychological improvement as they take ownership of their diagnosis.”Dr. Tapesh Pakrashi, Consultant Cardiologist / Heart Failure Lead
Who is it for?
For those with a diagnosis of:
- Heart failure
A diagnosis of heart failure will be confirmed by a test performed by your cardiologist. This will include:
Echocardiogram – the function of the left side of the heart (left ventricle) is expressed as an ejection fraction (or EF number). A normal EF is between 50-75 per cent. If it is less than 50% then a diagnosis of heart failure can be made.
Blood test – A specific marker in your blood can contribute to the diagnosis
Cardiac MRI – This is a very detailed assessment of the heart muscle and the extent to which the heart has been affected
The most common cause of heart failure is ischaemia, a restricted or inadequate blood supply to the heart muscle which can manifest itself as a heart attack. Other things can cause heart failure – arrhythmias, infections or excessive alcohol consumption. Sometimes the cause is not known.
When can I start?
This depends on your location on what is known as the “heart failure pathway” — an indicator of a propensity for, or probability of heart failure.
How does it work?
You can refer yourself by simply contacting us. We will then gather the relevant information. Alternatively, you can ask your GP to refer you. Frequently, your cardiologist, or the nurse specialist where you are treated will refer you directly.
Once a patient has been referred to Heartsure a member of the team will contact him or her directly.
An Initial Assessment (or IA) will be booked.
Initial Assessment (IA) – This is an individual session with your clinician.
In your first meeting we will discuss what your diagnosis actually means – the ejection fraction (EF), ischaemia, as well as any ongoing treatment.
Next, we will discuss medications. This is an opportunity to ask questions and to gain an understanding of your prescription medication.
In your IA we will record your Baseline Observations. This will consist of:
A physical assessment and signs of heart failure (fluid on ankles, body weight, etc.) We will take a detailed look at your:
- Blood pressure
- Resting ECG
- Cholesterol levels
- Oxygen saturation
- Lung function
- Weight and Height (BMI)
Your clinician will discuss the normal parameters for these factors.
We will then discuss your lifestyle, including diet, exercise habits and stress levels. Time will be spent identifying your risk factors and how they can contribute to the development of heart problems.
Lastly, an exercise assessment will identify any problems you have with movement or mobility. A simple walking test will be performed to assess your heart’s reaction to exercise. We will attach a small monitor to continuously record your heart rate. You will be introduced to a medically supervised exercise circuit where you will learn the correct way to exercise for your heart. Using heart rate monitors and other exercise assessment tools, we will gain an understanding of the level of exercise you need to benefit and improve your health and well-being.
Your session will consist of:
- A simple warm-up which, including stretching exercises
- A 6-8 station exercise circuit specifically designed for cardiac patients.
- An extended cool-down period and progressive stretches.
We can offer you a Polar activity device which allows the clinicians to assess your activity, track your steps, monitor your sleep and record your heart rate while exercising.
We will then devise an action plan and some personal short- and long-term goals.
A comprehensive report, which will include your personal goals and the action plan, will be compiled and sent to your cardiologist / surgeon / referring person and GP.
One-to-one medically supervised exercise sessions – weekly / regular sessions – with your clinician. At the start of each weekly or regular session you will have a health check-up, which will include your Baseline Observations.
There will then be the opportunity to discuss your progress since the last session. We will review any on-going symptoms and identify any problems and successes. If you are using a Polar activity device (example below), the data collected can be assessed and feedback given.
If for any reason you haven’t reached your goals, we will review the reasons and work together to get you back on track.
As you work with your clinician on a medically supervised exercise circuit, he/she can adjust and adapt the circuit to suit your needs.
At the end of each session we will summarise your achievements and set a plan for the time until your next session.
Discharge / review meeting – After a defined period of time from the start of your programme, there will be an appointment with your clinician and a review of your goals. New goals and future action plans will be set.
You will repeat the ‘Exercise Test’ and assess any improvements made with your fitness levels. A summary of goals will be discussed, with new challenges set for any which have not yet been achieved.
An updated progress report will be sent to your cardiologist / surgeon / referring person and GP.
How long will my programme last and how much will it cost?
“Successful health behaviour change programmes that involve exercise training, physical activity, risk factor management and psychosocial wellbeing require time to achieve the desired goals.”The National Audit Cardiac Rehabilitation 2017
You and your clinician will decide how long your programme will be.
- Initial Assessments and reports (120 minutes) – £220
- One-to-one medically supervised exercise sessions (75 minutes) – £90
- Discharge / review meeting (75 minutes) – £150
Some insurance companies cover our programmes. Please contact a member of the team to discuss further.