Digital Technologies in Cardiac Rehabilitation as a Complement to Center-Based Programs

Cardiovascular disease remains a leading cause of morbidity and mortality worldwide, and despite advances in acute-phase management and improved survival, long-term secondary prevention, functional recovery, and prevention of recurrent events remain critical components of care. Exercise-based cardiac rehabilitation (CR) is a well-established, evidence-based intervention that improves cardiorespiratory fitness, cardiovascular risk factor control, functional capacity, and quality of life, and is strongly recommended by major international and domestic clinical guidelines. However, participation in center-based cardiac rehabilitation (CBCR) remains suboptimal globally and in Korea, largely due to structural barriers such as limited accessibility, travel distance, time constraints, and competing work or caregiving responsibilities. National health insurance–based studies have demonstrated persistently low CR participation rates in Korea even after reimbursement coverage was introduced, and international audits have shown that cardiac rehabilitation density remains insufficient relative to population needs. In this context, digital technology–enabled cardiac rehabilitation—including home-based CR, telehealth-based CR, mobile health (mHealth), and other digital CR models—has emerged as a promising approach to complement CBCR by addressing participation barriers and resource limitations while enhancing accessibility and continuity of care. Accumulating evidence suggests that digital CR improves treatment adherence, cardiorespiratory fitness, and physical activity compared with usual care, and demonstrates clinical outcomes comparable to CBCR for major cardiovascular risk factors and events when appropriately applied. This review summarizes the conceptual framework, key components, implementation technologies, and clinical evidence for digital CR, and discusses important considerations for its adoption and integration into the Korean healthcare system.