Please select the eligibility criteria that correspond to the clinical trial below.
Title: Improving Delivery of Patient-Centered Cardiac Rehabilitation
Brief Summary: The long-term goal of this research is to improve patient-centered outcomes in patients with coronary heart disease (CHD), the leading cause of death in the world. Exercise-based cardiac rehabilitation (CR) programs decrease mortality and improve quality of life in patients with CHD. Published guidelines recommend exercise-based CR following hospitalization for myocardial infarction, coronary artery bypass grafting, or percutaneous coronary revascularization.

Despite these compelling benefits, CR programs are vastly underutilized, with less than a third of eligible patients participating. One promising solution is greater implementation of home-based CR. Both home and center-based CR programs have equal benefits on cardiovascular risk factors and quality of life. However, similar efficacy does not necessarily translate into similar effectiveness. If patients are more likely to participate in home- vs. center-based therapy, then greater participation could lead to greater clinical effectiveness. We are therefore conducting a quasi-experimental, controlled trial at two VA medical centers to determine the comparative effectiveness of referral to home- vs. center-based CR in patients with CHD.

Aim 1: Determine whether automatic referral to home- vs. center-based CR increases patient participation in CR after hospitalization for myocardial infarction or coronary revascularization.

Aim 2: Among patients who choose to participate in CR, compare the effectiveness of home- vs. center-based CR on six-minute walk distance, quality of life, and healthcare expenditures.

Aim 3: Determine whether the effects of home vs. center-based CR differ by age, gender, race, ethnicity, employment, socioeconomic status, social support, comorbid conditions, or patient preference.

Results from this study will (a) help policy makers determine the effect of covering home CR on healthcare expenditures in patients with CHD; (b) help providers understand the potential benefits and harms of home- vs. center-based CR; and (c) help patients answer questions like, "Given my personal circumstances and preferences, which of these options will improve the outcomes most important to me".


Options:
A: Inclusion Criteria:

1. aged 18 years or above
2. diagnosed with chronic heart failure
3. clinically stable as defined as symptoms and signs that have remained generally unchanged for at least 1 month
4. NYHA functional class II or III

Exclusion Criteria:

1. patients who have contraindications to cardiopulmonary test
2. patients who have contraindications to exercise training
3. Patients who have serious acute or chronic organic disease or mental disorders
4. history of cardiac surgery, cardiac resynchronization therapy, or intracardiac defibrillation within the previous 3 months;
5. history of cardiac arrest within 1 year;
6. history of peripartum cardiomyopathy, hyperthyroid heart disease, primary pulmonary hypertension;
7. inability to perform a bicycle stress test;
8. severe cognitive dysfunction precluding informed consent or understanding of exercise concepts;
9. current regular Baduanjin or current participation in a conventional cardiac rehabilitation program
10. current participation in another trial.
B: Inclusion Criteria:

* adults aged ≥18 years
* stable cardiovascular disease ; acute coronary syndrome; coronary artery bypass grafting within the previous six months
* ability to perform physical exercise,
* to speak, read and write Greek
* possession of a mobile phone/smartphone
* internet access at home

Exclusion Criteria:

* ventricular arrhythmia or myocardial ischemia during low to moderate exercise intensity as assessed by symptom limited exercise testing at baseline
* heart failure New York Heart Association (NYHA) class IV
* comorbidity precluding exercise training (e.g. orthopaedic, neurological or cognitive conditions)
* acute myocardial infarction (within two days)
* stenosis
* unstable angina
* uncontrolled atrial or ventricular arrhythmia
* aortic uncontrolled congestive heart failure
* acute pulmonary embolism
* acute myocarditis or pericardial effusion
* uncontrolled diabetes mellitus (Type I, II)
* hemodynamic instability or exercise-induced arrhythmia in baseline (initial) assessment
* severe obstructive respiratory disease
C: Inclusion Criteria:

* Recently underwent PCI.
* Are eligible for enrollment to the Cardiovascular Health Clinic (CVHC)
* Do not have any physical impediments to physical activity
* Do not have any impediments to physically attending the Mayo Clinic's CVHC
* They are willing to incorporate the software application into their CR
* They must have access to the internet

Exclusion Criteria:

* - They are unable or unwilling to enroll in CR
* They are unable to physically attend Mayo Clinic's CVHC CR Program
* They are unwilling to incorporate the Personal Health Assistant into their CR
D: Inclusion Criteria:

Post MI, CABG, or PCI Able to speak, read and write in english

Exclusion Criteria:

Class IV CHF Unstable Angina Complex Ventricular Arrythmias EF \<35% without AICD AICD candidate Resting SBP \>200mmHG Resting DBP\>110mmHG Cognitive Impairment by MoCA Score \<26 Life expectancy \<1 year

Answer: D