Credit Statement
Physicians 
The American College of Cardiology Foundation (ACCF) is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

The ACCF designates this online enduring matieral for a maximum of 5 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.  

MOC Information

Successful completion of this activity, which includes participation in the evaluation component, enables the participant to earn up to 5 Medical Knowledge MOC points in the American Board of Internal Medicine’s (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider’s responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.

Method of Participation and CME/MOC Certificate
Requesting AMA PRA Category 1 CME Credit™ Continuing Education and MOC credit for this activityTo request credit, you must:

1. View the recordings.
2. Complete the Evaluation and click on the Claim Credit button in the left navigation bar.
3. For CME, enter the total amount of time you actually spent in the activity in the box provided. Please note that you may only claim once for this activity. Click Claim.
4. For MOC credit, click the Claim button in the row for MOC. Please note that you may only claim once for this activity. Confirm your ABIM number and date of birth.
5. The page will be updated with the date and time that you claimed your credit.
6. To view your credit, or to print a certificate, please go to ACC.org and navigate to the My Transcript section of My ACC.

This CME/MOC-certified activity may contain links to other educational resources such as clinical trial summaries, journal articles, guidelines, etc., that may not be CME/MOC-certified. Please note that clicking on the links provided to view these resources will open new windows, which are outside of this CME/MOC-certified activity.

Learner Objectives
Upon completion of this program, you should be able to:

1. Describe the requirements for Individual Treatment Plans (ITPs).
2. Explain the role and responsibility of the Medical Director for both individual patient issues and overall program issues.
3. Distinguish which patients are appropriate for cardiac rehabilitation referral and enrollment.
4. Identify barriers to cardiac rehabilitation enrollment and practices that can decrease these barriers.
5. Describe how to construct an exercise prescription for most patients in phase 2 cardiac rehabilitation.
6. Explain the role of exercise stress testing before cardiac rehabilitation  to develop the exercise prescription and to evaluate improvement and return to work activities after cardiac rehabilitation.
7. Identify the benefits of cardiac rehabilitation in patients with coronary disease.
8. Evaluate how and when to enter coronary disease patients into cardiac rehabilitation for risk factor reduction.
9. Identify the mechanisms involved in the development of exercise intolerance in patients with heart failure (HF).
10. Explain the safety data for exercise testing and training for patients with HF.
11. Describe the clinical benefits, core components, and programmatic goals of cardiac rehab for patients with HF.
12. Establish safe parameters for cardiac rehabilitation and guide exercise training in cardiac transplantation patients and patients with implant of a left ventricular assist device (LVAD).
13. Describe how impaired gait, impairment in muscle strength, and the concept of frailty impact exercise prescription in the elderly.
14. Describe the effect of chronotropic incompetence on exercise.
15. Identify the interactions of rhythm device settings and exercise prescriptions.
16. Explain the benefits of cardiac rehabilitation post valve surgery.
17. Interpret the cardiac rehabilitation prescription for high complexity patients on cardiac rehab following transcatheter aortic valve replacement (TAVR).
18. Distinguish how to screen patients in cardiac rehabilitation for depression or anxiety, and how to motivate patients towards positive behavior change.
19. Describe the scope of tobacco use in patients in cardiac rehabilitation.
20. Apply practical pharmacotherapy to enhance tobacco cessation in patients in cardiac rehabilitation.
21. Identify the basics of tobacco cessation counseling.
22. Describe Phase 1 and Phase 3 cardiac rehabilitation.
23. Determine the role of non-center based cardiac rehabilitation.
24. Identify how lifestyle as treatment can reverse and prevent coronary heart disease and other chronic conditions.

Target Audience

This activity is intended for medical directors and physicians engaged in the care of patients in cardiac rehabilitation, and fellows in training.

Date of Release: January 18, 2023
Term of Approval/Date of CME/MOC Expiration: January 18, 2026

Chair:
Richard A. Josephson, MS, MD, FACC

Planning Committee:
Marjorie King, MD, FACC
Alison Bailey, MD, FACC
Melissa Tracy, MD, FACC
David M. Shipon, MD, FACC
John A. Larry, MD
Daniel E. Forman, MD

Faculty:
Mary Norine Walsh, MD, MACC
Steven J. Keteyian, PhD
Jonathan H. Whiteson, MD
Joel W. Hughes, PhD
Dean Ornish, MD

Learner Objectives
Upon completion of this program, you should be able to:

1. Describe the requirements for Individual Treatment Plans (ITPs).
2. Explain the role and responsibility of the Medical Director for both individual patient issues and overall program issues.
3. Distinguish which patients are appropriate for cardiac rehabilitation referral and enrollment.
4. Identify barriers to cardiac rehabilitation enrollment and practices that can decrease these barriers.
5. Describe how to construct an exercise prescription for most patients in phase 2 cardiac rehabilitation.
6. Explain the role of exercise stress testing before cardiac rehabilitation  to develop the exercise prescription and to evaluate improvement and return to work activities after cardiac rehabilitation.
7. Identify the benefits of cardiac rehabilitation in patients with coronary disease.
8. Evaluate how and when to enter coronary disease patients into cardiac rehabilitation for risk factor reduction.
9. Identify the mechanisms involved in the development of exercise intolerance in patients with heart failure (HF).
10. Explain the safety data for exercise testing and training for patients with HF.
11. Describe the clinical benefits, core components, and programmatic goals of cardiac rehab for patients with HF.
12. Establish safe parameters for cardiac rehabilitation and guide exercise training in cardiac transplantation patients and patients with implant of a left ventricular assist device (LVAD).
13. Describe how impaired gait, impairment in muscle strength, and the concept of frailty impact exercise prescription in the elderly.
14. Describe the effect of chronotropic incompetence on exercise.
15. Identify the interactions of rhythm device settings and exercise prescriptions.
16. Explain the benefits of cardiac rehabilitation post valve surgery.
17. Interpret the cardiac rehabilitation prescription for high complexity patients on cardiac rehab following transcatheter aortic valve replacement (TAVR).
18. Distinguish how to screen patients in cardiac rehabilitation for depression or anxiety, and how to motivate patients towards positive behavior change.
19. Describe the scope of tobacco use in patients in cardiac rehabilitation.
20. Apply practical pharmacotherapy to enhance tobacco cessation in patients in cardiac rehabilitation.
21. Identify the basics of tobacco cessation counseling.
22. Describe Phase 1 and Phase 3 cardiac rehabilitation.
23. Determine the role of non-center based cardiac rehabilitation.
24. Identify how lifestyle as treatment can reverse and prevent coronary heart disease and other chronic conditions.