Exercise Protocol for HF Rehabilitation — EECC MCQ

Correct answer: D — Moderate-intensity continuous training (MICT) at 60-70% peak HR for 20-60 min, 3-5 days/week is the standard protocol; high-intensity interval training (HIIT) may provide greater improvements in peak VO₂ but evidence for safety is still evolving — supervised programmes are recommended initially

Exercise prescription for HF per the 2023 ESC HF Guidelines and cardiac rehabilitation consensus: (1) Aerobic: moderate-intensity continuous training (MICT) at 60-70% of peak heart rate (or 40-60% VO₂ reserve/HRR), 20-60 min per session, 3-5 days/week — this is the best-evidenced protocol (HF-ACTION); (2) HIIT (e.g. 4×4 min at 85-95% peak HR with 3 min recovery intervals): may produce greater VO₂ peak improvements (SMARTEX-HF showed similar safety but not clearly superior outcomes); (3) Resistance training: moderate intensity (40-60% 1RM), 2-3 days/week, 8-10 exercises (improves peripheral muscle strength, which is independently impaired in HF); (4) Supervised initially (6-12 weeks), then transition to home-based; (5) Contraindications: decompensated HF, recent ACS (<48h), severe AS, uncontrolled arrhythmias.

Reference: ESC (2023): HF Guidelines; HF-ACTION Trial