Impact of an online cardiac rehabilitation program after an acute coronary syndrome during SARS-CoV-2 pandemic

Abstract

Funding Acknowledgements Type of funding sources: Public hospital(s). Main funding source(s): Hospital Universitario La Paz Introduction The SARS-CoV-2 pandemic has overloaded health care systems at several fields. Spanish COVID-19 first wave led to the interruption of most cardiac rehabilitation (CRH) programs in our country. Resume activity without compromising patient"s safety has been a challenge. At our centre (a third-level hospital), we modified our routine clinical practice from face-to-face interviews to a complete online CRH program since July 1st 2020. Purpose The aim of this study is to analyse the impact of an online CRH program after hospital discharge for an acute coronary syndrome in health goals and adherence to secondary prevention measures at the end of the program. Methods This is a retrospective study made up of patients who, after suffering an acute myocardial infarction, followed an online CRH program from June to November 2020. A first online assessment is made by a cardiology consultant. Then, it is followed by ten online group interviews of up to three patients and a health care proffesional: either a nurse or a physiotherapist. These interviews last around ninety minutes. Four weeks after, an online follow-up interview is made by a cardiology consultant. These interviews focus either on physical exercise instructions (aerobical exercise and endurance exercise) or educational interviews (ischemic cardiomyopathy, Mediterranean diet, pharmacological treatment, sexual dysfunction, stress management techniques and solution of questions). Results Up to eighty-four patients were included in our CRH program (this means 83% of patients discharged from our hospital after an acute coronary event). Median of time from discharge to first online interview was 8"79 days and from this last one to program beginning, 3"67 days. Four weeks after the beginning of the program, 82% of the patients presented with a LDL-cholesterol level below aim level (< 55 mg/dL). Workout, Mediterranean diet and tobacco abstinence observance rates were over 90%. There were just three patients who gave up or did not complete the program. Conclusion Despite the fact that SARS-CoV-2 pandemic has arisen a huge challenge for ongoing CRH programs in Spain, the benefit that has been showed by them on cardiovascular health, makes it necessary to develop new tools to allow them going on. New technologies are an opportunity for us to keep on following these patients, moreover showing good results as for adherence, availability and patient and operator assesssment.