Comprehensive Hybrid Cardiac Rehabilitation Trial on Heart Failure

Inclusion Criteria:

• Adult patients with HF of New York Heart Association functional class II or III.

• Meets HF diagnostic criteria of Guidelines

• On optimal tolerated medical therapy.

• Deemed by the treating physician as stable for at least 1 month.

• Able to attend the health center three times a week for the first month, and twice aweek for the 2nd and 3rd months

• Owns a mobile phone

• Patient consents to participate in the study by signing an informed consent form.

Exclusion Criteria:

• Chronic kidney disease with glomerular filtration rate < 20 mL/min.

• Decompensated thyroid disease.

• End-stage liver failure or Child-Pugh C.

• Cardiac device or cardiac surgery in the previous month or planned in the next 3months.

• Patients with dyspnea predominantly of non-cardiac cause (e.g. COPD).

• Atrial fibrillation with a heart rate greater than 90 beats per minute at rest.

• Active neoplasm with life expectancy <2 years.

• Inclusion in another interventional study.

• Explicit contraindications to performing exercise.

• Comorbidities that preclude the patient from engaging in a CR program.

• Musculoskeletal or neurological disease that precludes the patient from performingexercise.