Aims Despite strong recommendations, outpatient cardiac rehabilitation is underused in chronic heart failure (CHF) patients. Possible barriers are frailty, accessibility, and rural living, which may be overcome by telerehabilitation. We designed a randomized, controlled trial to evaluate the feasibility of a 3‐month real‐time, home‐based telerehabilitation, high‐intensity exercise programme for CHF patients who are either unable or unwilling to participate in standard outpatient cardiac rehabilitation and to explore outcomes of self‐efficacy and physical fitness at 3 months post‐intervention. Methods and results CHF patients with reduced (≤40%), mildly reduced (41–49%), or preserved ejection fraction (≥50%) (n = 61) were randomized 1:1 to telerehabilitation or control in a prospective controlled trial. The telerehabilitation group (n = 31) received real‐time, home‐based, high‐intensity exercise for 3 months. Inclusion criteria were (i) ≥18 years, (ii) New York Heart Association class II‐III, stable on optimized medical therapy for >4 weeks, and (iii) N‐terminal pro‐brain natriuretic peptide >300 ng/L. All participants participated in a 2‐day ‘Living with heart failure’ course. No other intervention beyond standard care was provided for controls. Outcome measures were adherence, adverse events, self‐reported outcome measures, the general perceived self‐efficacy scale, peak oxygen uptake (VO2peak) and a 6‐min walk test (6MWT). The mean age was 67.6 (11.3) years, and 18% were women. Most of the telerehabilitation group (80%) was adherent or partly adherent. No adverse events were reported during supervised exercise. Ninety‐six per cent (26/27) reported that they felt safe during real‐time, home‐based telerehabilitation, high‐intensity exercise, and 96% (24/25) reported that, after the home‐based supervised telerehabilitation, they were motivated to participate in further exercise training. More than half the population (15/26) reported minor technical issues with the videoconferencing software. 6MWT distance increased significantly in the telerehabilitation group (19 m, P = 0.02), whereas a significant decrease in VO2peak (−0.72 mL/kg/min, P = 0.03) was observed in the control group. There were no significant differences between the groups in general perceived self‐efficacy scale, VO2peak, and 6MWT distance after intervention or at 3 months post‐intervention. Conclusions Home‐based telerehabilitation was feasible in chronic heart failure patients inaccessible for outpatient cardiac rehabilitation. Most participants were adherent when given more time and felt safe exercising at home under supervision, and no adverse events occurred. The trial suggests that telerehabilitation can increase the use of cardiac rehabilitation, but the clinical benefit of telerehabilitation must be evaluated in larger trials.

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Objectives: Reduced left ventricular (LV) diastolic function indicates poor prognosis after acute myocardial infarction (AMI). Our aim was to study whether a twelve-week high-intensity interval training program could improve diastolic function in patients with a relatively recent AMI. Design: Twenty-eight patients (mean age 56 (SD 8) years) with a recent AMI performed high-intensity interval training twice a week for 12 weeks. Each training session consisted of four 4-minute bouts at 85%-95% of peak heart rate, separated by 4-minute active breaks. A cardiopulmonary exercise test was performed to determine peak oxygen uptake (VO 2peak ). Echocardiography was performed at rest and during an upright bicycle exercise test.Results: There was a significant increase in mitral annulus early diastolic velocity (e′) at peak exercise (75 W) from baseline to follow-up (7.9 (1.5) vs. 8.4 (1.7) cm/s, P = .012), but no change in e′ at rest (7.1 (1.9) vs. 7.3 (1.7) cm/s, P = .42). There was a significant increase in VO 2peak (mean (SD), 35.2 (7.3) vs. 38.9 (7.4) ml/kg/min, P < .