Home-Based CR of Patients That Declined Traditional CR 33C ardiac rehabilitation (CR) is well recognized as an essential intervention for the secondary prevention of coronary artery disease, heart failure (HF), and future heart-related complications. 1 Benefits of CR include improvements in morbidity, physical activity (PA) level, exercise capacity, and quality of life as well as decreased rate of hospital admissions. 2 A viable alternative to traditional, center-based cardiac rehabilitation (CBCR) is asynchronous home-based cardiac rehabilitation (HBCR). 3 Similar to CBCR, HBCR has already been well established and shown to deliver similar outcomes and safety profile. 4 However, unlike traditional CR programs, HBCR has the additional benefits of being more cost-effective and easily accessible. 5,6 Previous research 7,8 has found that patients who are referred by their physicians to CR are often unwilling to actively participate in the traditional CR. The reasons for this unwillingness to participate in CR are varied and can be broken down into person-specific factors and reasons which are related to the CR program. Documented person-specific factors such as older age, female sex, patients with comorbidities, unemployed persons, lower education levels, and lower incomes were correlated to lower participation rates. Specific reasons, which were related to the CR program, included distance from CR facilities, lack of adequate transportation, and program hours. 9 Other studies have documented outright patient refusal to initiate a traditional CR program, citing factors such as a general