Valvular & structural heart disease

Cardiac rehabilitation after transcatheter aortic valve implantation before, during and after the COVID-19 pandemic: a whole-population study

HeartPublished retrospective cohort study

Main finding · Unplanned all-cause rehospitalisationResult — go to the resultHazard ratio 0.88 95% CI 0.79–0.98

Authors' conclusion

CR after TAVI declined during the first COVID-19 lockdown but rebounded quickly. CR was associated with lower all-cause and non-cardiovascular rehospitalisation but was not associated with lower HF rehospitalisation or mortality. More research is needed to confirm these clinical findings.

Study context

Population
All transcatheter aortic valve implantation (TAVI) recipients in England (2018–2023)TAVI recipients, 1090 (4.4%) attended cardiac rehabilitation (CR)
Participants
24,925 recipients
Exposure
CR participation vs no CR participation after TAVI
  • CRn = 1,090
Outcome
unplanned all-cause rehospitalisation
Follow-up
Was up to 5 years, with a minimum of 12 months
Methodological detailswhole-population electronic health records
  • Whole-population electronic health records

Main finding

As reported in the abstract

Hazard ratio

0.88

95% CI 0.79–0.98

P = 0.019

By group

CR participationvs no CR participation after TAVI
HR 0.88 (95% CI 0.79–0.98); P = 0.019

Observational data: associations, not effects.

Secondary outcomes

Heart failure (HF) rehospitalisation

Rate, per 10 000 person-days

CRnon-CRHR (95% CI)P value
CRAdjusted; no evidence of an association1.051.020.94 (0.75–1.19)P = 0.607

Non-cardiovascular rehospitalisation

Rate, per 10 000 person-days

CRnon-CRHR (95% CI)P value
CRAdjusted; lower risk with CR4.534.820.84 (0.76–0.94)P = 0.002

Mortality

Rate, per 10 000 person-days

CRnon-CRHR (95% CI)P value
CRAdjusted; no evidence of an association3.613.840.95 (0.84–1.07)P = 0.383

CR rates by pandemic period

First COVID-19 lockdown
1.57 per 10 000 person-days
Post pandemic
3.24

Original publication

Cardiac rehabilitation after transcatheter aortic valve implantation before, during and after the COVID-19 pandemic: a whole-population study. Heart. Published 3 April 2026. doi:10.1136/heartjnl-2025-327186

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