[Initial results with a comprehensive ambulatory rehabilitation program for heart patients].

213 patients (197 males and 16 females, mean age 58.5 years) have taken part during the first 5 years in our comprehensive out-patient cardiac rehabilitation program (101 patients after acute myocardial infarction, 73 patients after heart surgery and 39 patients with various cardiac problems). The program consists of three elements: (1.) regular physical training in an out-patient group three times a week for 6-12 weeks; (2.) information and education of the patient and if possible of the family about risk factors and life-style changes, and (3.) psychosocial support. During 10,838 hours of active rehabilitation, no life-threatening complication occurred. After completion of the program, 73% of the patients were fully rehabilitated (return to work in the active working population, reintegration in the family and daily life in the retired and non-working patients), 15% of the patients interrupted the program because of further invasive treatment, and in 11% the goal of the rehabilitation program was not achieved. Follow-up was carried out by a questionnaire 3-56 months (mean 25 months) later. The percentage of smokers decreased from 55% before the program to 18% (p < 0.05), regular physical exercise increased from 49% to 76% (p < 0.05), and the perceived stress level of high intensity decreased from 53 to 9% (p < 0.05). Our findings indicate that a comprehensive cardiac rehabilitation program in an out-patient setting in conjunction with a community hospital is feasible; it can be conducted with a high degree of safety and is followed by considerable lifestyle changes.