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


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.
Heart Failure Unit, Cardiac Department, G. da Saliceto Polichirurgico Hospital, Piacenza, Italy.|Fondazione Gabriele Monasterio, CNR, Pisa, Italy.
Massimo F
MF
Piepoli
Heart Failure Unit, Cardiac Department, G. da Saliceto Polichirurgico Hospital, Piacenza, Italy.
Simone
S
Binno
Department of Cardiology, Fondazione Salvatore Maugeri, IRCCS Scientific Institute of Veruno, Veruno, Italy.
Ugo
U
Corrà
Department of Cardiology, Clinical Center of Serbia, University of Belgrade School of Medicine, Belgrade, Serbia.
Petar
P
Seferovic
Department of Cardiology and Cardiac Rehabilitation, Antwerp University Hospital, Edegem, Belgium.
Viviane
V
Conraads
Department of Social and Welfare Studies, University of Linkoping, Sweden.
Tiny
T
Jaarsma
University of Bern, Bern, Switzerl.
Jean-Paul
JP
Schmid
Heart Failure Unit at the Department of Cardiology, Athens University Hospital Attikon, Greece.
Gerasimos
G
Filippatos
Department of Heart Diseases, Wroclaw Medical University, Wroclaw, Poland.
Piotr P
PP
Ponikowski
D003325:Coronary Care Units; D005060:Europe; D005081:Exercise Therapy / Q000706:statistics & numerical data*; D019538:Health Care Surveys; D006333:Heart Failure / Q000534:rehabilitation*; D006801:Humans; D020407:Internet; D012047:Rehabilitation Centers / Q000191:economics; D011795:Surveys and Questionnaires
Cardiac rehabilitation; Cardiovascular disease; Europe; Prevention