Cardiac Programme

This programme requires the approval and participation of your local Medical Practitioner in monitoring your progress throughout the programme in addition to his agreement to your participation. It is therefore essential that you discuss your involvement with your doctor. You will have available all the resources normally present in a cardiac programme including a case manager who will monitor your progress and liase with you doctor. In addition paramedical workers eg dieticians, psychologists, exercise physiologists will be available for assistance when necessary.

Risk Classification for Exercise Training: Class B

This classification includes individuals with any of the following diagnoses:

1. Coronary artery disease (myocardial infarction, bypass surgery, angioplasty angina pectoris, abnormal exercise test, and abnormal coronary angiograms) whose condition is stable and who have the clinical characteristics below
2. Valvular heart disease, excluding severe valvular stenosis or regurgitation with the clinical characteristics below
3. Cardiomyopathy: ejection fraction < 40%: includes stable patients with heart failure excluding hypertrophic cardiomyopathy or recent myocarditis.

Clinical characteristics (must include all of the following)

1. New York Heart Association class 1 or 2
2. Exercise capacity > 6 mets
3. No evidence of congestive cardiac failure
4. No evidence of myocardial ischaemia or angina at rest or on the exercise test at or below 6 mets
5. Appropriate rise in systolic blood pressure during exercise
6. Absence of sustained or non sustained ventricular tachycardia at rest or with exercise
7. Ability to satisfactorily self-monitor intensity of activity.

Activity Guidelines:

Activity must be individualised with appropriate exercise prescription provided by qualified individuals including target heart rates and limitations and approved by primary health care provider.

Supervision required:

Appropriate trained non-medical personnel should be present until the individual understands how to monitor his or her activity. Non-medical personnel should be trained in Basic Life Support. Medical supervision is beneficial during the initial prescription session. Blood pressure monitoring with or without ECG during the early phase of training.

Programme Recommended:

Nu-Life Cardiac Programme with Clinical Support Service.

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For Those at Moderate-High Risk for Cardiovascular Complications during Exercise and/or Unable to self-Regulate Activity or Understand Recommended Activity Levels.

Risk Classification for Exercise Training: Class C

This classification includes individuals with any of the following diagnoses:

1. Coronary artery disease with the clinical characteristics outline below
2. Valvular heart disease ,excluding severe valvular stenosis or regurgitation with the clinical characteristics as outlined below
3. Cardiomyopathy: Ejection fraction < 30% includes stable patients with heart failure with clinical characteristics as outlined below but not hypertrophic cardiomyopathy or recent myocarditis.
4. Complex ventricular arrhythmias not well controlled.

Clinical Characteristics (any of the following)

1. NYHA Class 3-4
2. Exercise test results
   • a. capacity < 6 mets
   • b. Angina or ischaemic ST depression at a workload<6mets
   • c. Fall in systolic BP > 20mmHg
   • d. Non sustained VT with exercise
3. Previous episode of primary cardiac arrest (i.e. cardiac arrest that did not occur in the presence of acute myocardial infarct or during a cardiac procedure.
4. A Medical problem that the physician believes may be life-threatening

Activity Guidelines:

Activity must be indivudualised with appropriate exercise prescription provided by a qualified individual.

Supervision Required:

Appropriately trained senior nursing staff with Advance Life Support Certification in a properly equipped exercise facility with full resuscitation equipment.

Programme Recommended:

Out Patient Accredited Nu-Life Cardiac Programme Facility

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