ExtraHF survey: the first European survey on implementation of exercise training in heart failure patients

Massimo F Piepoli, Simone Binno, Ugo Corrà, Petar Seferovic, Viviane Conraads, Tiny Jaarsma, Jean-Paul Schmid, Gerasimos Filippatos, Piotr P Ponikowski, Committee on Exercise Physiology & Training of the Heart Failure Association of the ESC, Birna Bjarnason-Wehrens

Publication: Contribution to journalJournal articlesResearchpeer-review


AIMS: In heart failure (HF), exercise training programmes (ETPs) are a well-recognized intervention to improve symptoms, but are still poorly implemented. The Heart Failure Association promoted a survey to investigate whether and how cardiac centres in Europe are using ETPs in their HF patients.

METHODS AND RESULTS: The co-ordinators of the HF working groups of the countries affiliated to the European Society of Cardiology (ESC) distributed and promoted the 12-item web-based questionnaire in the key cardiac centres of their countries. Forty-one country co-ordinators out of the 46 contacted replied to our questionnaire (89%). This accounted for 170 cardiac centres, responsible for 77,214 HF patients. The majority of the participating centres (82%) were general cardiology units and the rest were specialized rehabilitation units or local health centres. Sixty-seven (40%) centres [responsible for 36,385 (48%) patients] did not implement an ETP. This was mainly attributed to the lack of resources (25%), largely due to lack of staff or lack of financial provision. The lack of a national or local pathway for such a programme was the reason in 13% of the cases, and in 12% the perceived lack of evidence on safety or benefit was cited. When implemented, an ETP was proposed to all HF patients in only 55% of the centres, with restriction according to severity or aetiology.

CONCLUSIONS: With respect to previous surveys, there is evidence of increased availability of ETPs in HF in Europe, although too many patients are still denied a highly recommended therapy, mainly due to lack of resources or logistics.

Original languageEnglish
JournalEuropean journal of heart failure
Issue number6
Pages (from-to)631-638
Number of pages8
Publication statusPublished - 06.2015


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