[Heart groups in Germany-current situation and prospects].

Currently, more than 6,600 heart groups (AHGs) have been established in Germany, in which more than 110,000 patients are physically active. Following cardiac rehabilitation (CR) after an acute event, in the AHG patients aim to meet the set rehabilitation goals in groups of about 15-20 patients, instructed by a competent exercise therapist and attended by a physician. While physical activity has been the dominant aspect thus far, psychosocial and educative elements are now more strongly integrated to stabilize secondary prevention. According to the German rehabilitation law, the patient is legally entitled to participate in AHGs. The insurance companies pay 6.00 Euros for 90 therapeutic units at 60-90 min each. Thereafter, the patient should be encouraged to continue participation at his/her own cost. The opportunity to participate in AHG is not yet sufficiently responded to by the patients. According to different studies, only 13-40% of all patients attend an AHG after phase II CR. In future, special emphasis has to be placed on the recruitment of more patients into AHGs, especially those groups which are known to be underrepresented (e. g., women, old patients, patients with low socioeconomic status). Furthermore, AHGs have to be established for patients with special needs, e. g., heart failure patients or young grown-ups with congenital heart diseases. Until now, the efficiency of AHG participation has not been sufficiently investigated. In a case-control study analyzing the long-term results of AHG participation, an improvement in physical performance as well as a reduction of cardiovascular morbidity (54%) and medical costs (approximately 47%) were observed. In future, more high-class investigations on this field are needed.