Cardiac rehabilitation is a structured programme of exercise, education, and psychological support designed to help you recover after a cardiac event. For cardiac arrest survivors it can be genuinely transformative — yet it is also one of the most inconsistently delivered parts of post-arrest care, with many survivors either not offered it at all or offered a programme that wasn’t designed with them in mind.
What Does Cardiac Rehab Involve?
A good cardiac rehab programme typically covers several areas: graduated physical exercise tailored to your current fitness and cardiac status; education about your condition, medications, and lifestyle; dietary guidance; and psychological support to help you manage the emotional aftermath of what you’ve been through. Programmes vary considerably between hospitals and regions in terms of what they offer and how they deliver it — some are group-based, some individual, and many now have an online or home-based option.
The Four Phases
Cardiac rehabilitation is traditionally divided into four phases. Phase 1 begins in hospital, usually while you are still an inpatient, and involves early mobilisation and basic education. Phase 2 covers the immediate period after discharge — typically a telephone or home visit from a cardiac rehab nurse to monitor your recovery and answer questions. Phase 3 is the main outpatient programme, usually a six to eight week course of supervised exercise and education sessions. Phase 4 is long-term maintenance, helping you sustain the gains you’ve made independently through community or home-based activity.
The Problem for Cardiac Arrest Survivors
Here is where it gets frustrating. Cardiac rehab provision in the UK has historically been organised around heart attack patients. If your cardiac arrest was caused by a heart attack, you are likely to be referred automatically. But if your arrest was caused by an arrhythmia, a channelopathy, or was idiopathic — as is the case for a significant proportion of our members — you may find yourself discharged without any referral at all.
This is despite the fact that the physical deconditioning, psychological trauma, cognitive difficulties, and fatigue experienced by cardiac arrest survivors are just as real, and often more pronounced, than those experienced after a straightforward heart attack. The Resuscitation Council UK Quality Standards are clear that all cardiac arrest survivors should be assessed for rehabilitation needs — but implementation is patchy.
If you were not referred, ask. Speak to your GP or cardiologist and specifically request a cardiac rehab referral. You are entitled to it.
If You Missed Out
If you were not offered cardiac rehab, or if some time has passed since your arrest, a Phase 4 programme may still be available to you. These are community-based, long-term exercise programmes run by qualified instructors trained to work with cardiac patients. They are available across the UK and are not dependent on having recently been discharged from hospital.
Use the National Audit of Cardiac Rehabilitation finder to locate programmes near you, or ask your GP to refer you to your local cardiac rehab team directly.
Exercising with an ICD
Many cardiac arrest survivors have an ICD fitted, which can understandably create anxiety around physical activity. A well-run cardiac rehab programme will be familiar with this and will tailor your exercise prescription accordingly. Supervised exercise in a monitored environment is often the best way to rebuild confidence, as it gives you the experience of raising your heart rate safely — with qualified support around you if needed.
Our virtual fitness clubs offer a peer-supported alternative for those who want to get active alongside others who understand the particular experience of exercising after a cardiac arrest.
Home-Based Resources
If you are waiting to start a programme, or prefer to exercise at home, the following resources are a good starting point. Always check with your cardiologist or cardiac rehab team before beginning any new exercise programme after a cardiac arrest.
Useful external resources:
- British Heart Foundation — Cardiac Rehabilitation
- NHS — Recovery and Rehabilitation
- Association of Chartered Physiotherapists in Cardiovascular Rehabilitation — Patient Leaflets