After a heart attack: how cardiac telerehabilitation can better support patients

Cardiac rehabilitation usually combines several components: a gradual return to physical activity, patient education and psychological support. France’s National Authority for Health (HAS) adds treatment optimization, risk factor management and preparation for returning to work.

Yet access remains limited. According to the HAS report on referral to cardiac rehabilitation, after an acute coronary syndrome only 30% of men and 25% of women in France are referred to a rehabilitation program. A study by Santé publique France, the national public health agency, shows that admission rates rose from 16% to 22% between 2009 and 2019, but remain lower among women, older people and in some regions.

The challenge is therefore not only how to treat an acute cardiovascular event, but also how to support more patients in the weeks and months that follow.

This is the challenge Ensweet’s cardiac telerehabilitation solution addresses. The principle: allowing some patients, when their medical team considers them eligible, to follow part of their program from home while being supported remotely by a multidisciplinary team.

Ensweet combines a platform for healthcare professionals with a mobile app for patients. It supports adapted physical activity sessions, patient education content and the transmission of certain data to care teams, including heart rate recorded during sessions.

Travel, limited availability of rehabilitation centers or returning to work can make it harder to take part in a traditional program. Santé publique France also reports marked differences between regions.

Telerehabilitation brings more flexibility. According to Ensweet, patients can complete some sessions from home, at times that fit their personal schedule, while still being followed remotely by healthcare professionals. That follow-up has the same requirements as any remote patient monitoring: a clear clinical scope and an organized response.

The HAS also lists telerehabilitation and hybrid programs among the ways to deliver cardiovascular rehabilitation, and notes that low-risk patients may be eligible for home-based programs.

The conversation with Valentine Antoine highlights an important shift: cardiovascular care does not end when the patient leaves the hospital.

After a cardiac event, secondary prevention becomes essential. It relies in particular on adapted physical activity, treatment adherence, patient education and changes in certain behaviors.

Cardiac rehabilitation is backed by strong evidence. In people with coronary heart disease, the HAS reports a 26% reduction in cardiovascular mortality and an 18% reduction in rehospitalizations, including in recent studies reflecting modern management of acute coronary syndrome.

The question then becomes: how can more patients benefit from it?

This is probably one of the most interesting aspects of Ensweet’s approach. Digital tools are not used to fully automate the pathway, but to let healthcare professionals follow their patients differently.

In the pathways described by the company, part of the rehabilitation takes place in a facility and then continues at home, with different levels of supervision depending on the patient’s profile.

This combination of physical care, human support and digital tools reflects a broader shift in healthcare: part of patient follow-up can gradually move out of the hospital and into everyday life.

To learn more about Ensweet’s solution and work, visit the Ensweet website.

At MyTwin, this shift ties directly into our vision of the patient digital twin.

Our ambition is to gradually bring together different health data to build an evolving representation of each patient: cardiovascular data, physical activity, sleep, lab results, treatments, medical history and other relevant signals.

In cardiovascular care, a digital twin could help better understand how a patient evolves over time and put into context the real-world data collected before, during and after rehabilitation.

Solutions like Ensweet illustrate an important step in this transformation: making the home a genuine extension of the care pathway, without breaking the link with healthcare professionals.

In the end, the MyTwin Inside episode with Ensweet raises a central question for preventive medicine: once a patient has been saved during an acute event, how can technology help support them over time and keep them from falling off the healthcare system’s radar?