## 2 Methods
### Intervention in a Training Group  
The training group patients undergo the HCR program, consisting of 1 month of hospital-based rehabilitation and 2 months of home-based telemonitored rehabilitation. Every patient is followed for one year after the HCR program. Hybrid cardiac rehabilitation contains all key elements of comprehensive cardiac rehabilitation: education, exercise training, psychological support, tobacco cessation and, if needed, blood pressure, lipid and diabetes management. Exercise training is planned according to the published guidelines [17; 18; 19; 20; 21; 22; 23]. The HCR program consists of endurance, resistance, strength, and respiratory training. The details are presented in Table 2. Patients train five times a week.  
The methodology of telemonitoring during home-based cardiac rehabilitation has been presented in the past [24; 25; 26; 27]. In summary, every TG patient receives the device (the telerehabilitation set) for telemonitoring and guided exercise training (Pro Plus Company, Poland), composed of an EHO mini device that records and transmits the ECG and blood pressure measurements, a body scale, and a mobile phone.  
\begin{table}
\begin{tabular}{c c} \hline \hline
**Inclusion Criteria** & \\ \hline \(\bullet\) & Patients with hypertrophic cardiomyopathy (defined in accordance with European Society of Cardiology guidelines for the diagnosis and management of cardiomyopathy and hypertrophy in 2014): thickness \(\geq\) 15 mm of one or more segments of the left ventricular wall measured using an imaging technique, which cannot be explained entirely by left ventricular loading conditions, without left ventricular outflow tract obstruction (at rest gradient \textless{}30 mmHg). \\ \(\bullet\) & Stable general condition (1 month period). \\ \(\bullet\) & Heart failure—New York Heart Association Classes II and III. \\ \(\bullet\) & Preserved left ventricle systolic function (ejection fraction \(\geq\) 50\%). \\ \(\bullet\) & Implanted cardioverter-defibrillator. \\ \(\bullet\) & Written informed consent. \\ \(\bullet\) & Adult patient (\(\geq\)18 years old). \\ \hline \hline \end{tabular}
\begin{tabular}{c c} \hline \hline \(\bullet\) & Life-threatening ventricular arrhythmias not amenable to treatment. \\ \(\bullet\) & Poorly controlled hypertension or diabetes. \\ \(\bullet\) & Advanced atrioventricular block. \\ \(\bullet\) & Aortic stenosis with symptoms. \\ \(\bullet\) & Pericarditis or myocarditis (up to 6 months). \\ \(\bullet\) & Thrombus in the heart cavities. \\ \(\bullet\) & Relevant ischemia caused by low-intensity exercise test (2 metabolic equivalents, 50 Watts). \\ \(\bullet\) & Pulmonary embolism (up to six months). \\ \(\bullet\) & Thrombbleitis. \\ \(\bullet\) & A new incident of atrial fibrillation or atrial flutter. \\ \(\bullet\) & Drop in systolic blood pressure during exercise. \\ \(\bullet\) & Acute systemic illness. \\ \(\bullet\) & Coexisting diseases limiting exercise tolerance and physical activity. \\ \hline \hline \end{tabular}
\end{table}
Table 1: Inclusion/exclusion criteria.  
An EHO device is designed to register 16 s-5 min pieces of ECG recording from three precordial leads and transmit the data via a mobile phone network to the monitoring center. This device has training sessions programmed personally for every patient (established exercise duration, intervals or coordination of ECG registration). The moments of automatic ECG recording are preset and harmonized with the exercise training [24].  
Before every training session, participants answer questions concerning their current health status and medicaments taken by mobile phone. Then patient transmits ECG at rest, blood pressure and weight data to the monitoring center. If no contraindications to training are recognized, participants receive approval to begin a training session. If no adverse events occur, a patient sends out an ECG recording to the monitoring center immediately after each training session. The data are stored and analyzed in the Telecardiology Center.