Rationale for Patient Selection Criteria
Most studies of exercise training for individuals with CHF were carried out in individuals with stable NYHA class II and III symptoms thus class IV patients are presently excluded. All patients should be clinically stable prior to embarking on CR, thus the above recommendations build in a required period of at least one month of clinical stability after an index hospitalization.
Contraindications to CR exercise training also include uncontrolled diabetes or hypertension, moderate to severe aortic stenosis, hypertrophic obstructive cardiomyopathy, significant ischemia at < 2 metabolic equivalents (METs) of work, any co-morbidity that prevents exercise participation, or acute myocarditis or other acute cardiomyopathy until stabilized.