Novel approaches to cardiac rehabilitation among patients with cardiovascular disease: current and future states

PURPOSE OF REVIEW: Novel approaches to cardiac rehabilitation delivery, the integration of emerging exercise modalities, and the extension of cardiac rehabilitation principles to additional disease states have the potential to improve care for patients with established and evolving indications. This review summarizes recent advances in hybrid and home-based cardiac rehabilitation, digital and behavioral technologies, innovative exercise strategies, and the application of cardiac rehabilitation to broader patient populations. RECENT FINDINGS: Technology-enabled cardiac rehabilitation models - including hybrid delivery, remote monitoring, wearables, gamification, and behavioral-economic nudges - demonstrate promise in improving participation, adherence, and engagement. Concurrently, newer exercise modalities offer more personalized and physiologically targeted programs. Evidence supports expanding cardiac rehabilitation to additional clinical populations, including individuals with heart failure with preserved ejection fraction and cardio-oncology, and demonstrates meaningful benefits in older and frail adults, with improvements in exercise capacity, symptoms, and quality of life. SUMMARY: Advances in digital health, behavioral science, and exercise physiology are increasingly reshaping cardiac rehabilitation, moving beyond traditional, center-based models toward more flexible, patient-centered, and data-enabled approaches to cardiovascular care. Further research is needed to refine implementation, evaluate long-term outcomes, and ensure equitable access. Integrating novel exercise modalities with technology-enabled and behavioral approaches may help modernize cardiac rehabilitation and extend its therapeutic reach.