Abstract

Background: Hybrid cardiac rehabilitation (CR) combining supervised and home-based phases with wearable monitoring may improve access and outcomes after myocardial infarction (MI). Objective: To assess the impact of a 14-week hybrid CR program on functional class, exercise capacity, hemodynamics, body composition, and physical activity in post-MI patients with NYHA class II symptoms. Methods: Sixty-six adults post-MI underwent 2 weeks of in-hospital initiation followed by 12 weeks of home-based rehabilitation via a smartwatch–smartphone platform. Within-subject changes from baseline to week 14 were analyzed using appropriate paired statistical tests. Results: NYHA class improved significantly, with 39% of participants downgrading their class (p < 0.001). Body weight decreased by 1.27 ± 2.51 kg (p < 0.001). Systolic and diastolic blood pressures declined (both p ≤ 0.002). Maximal METS rose markedly (25.7% increase; p < 0.001), and watts/kg improved (p < 0.001). Resting heart rate decreased (p = 0.002); peak exercise heart rate change was non-significant. Fat mass declined and skeletal muscle mass increased (mean gain 0.98 kg; p < 0.001). Daily step count increased from 5550 ± 2026 to 7267 ± 2500 steps (p < 0.001). Total body water also increased (p < 0.001). Conclusions: The hybrid CR program produced significant improvements in functional class, exercise capacity, blood pressure, body composition, and physical activity in post-MI NYHA II patients, supporting its effectiveness as a remotely enabled secondary prevention strategy. However, the results are based on hypotheses and randomized controlled trials must confirm the benefits especially with a control group. Nonetheless, it is a feasible and potentially effective alternative to conventional programs in resource-limited settings.

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