Heart Failure Reviews

, Volume 18, Issue 1, pp 95–105

Should high-intensity-aerobic interval training become the clinical standard in heart failure?

  • Ross Arena
  • Jonathan Myers
  • Daniel E. Forman
  • Carl J. Lavie
  • Marco Guazzi

DOI: 10.1007/s10741-012-9333-z

Cite this article as:
Arena, R., Myers, J., Forman, D.E. et al. Heart Fail Rev (2013) 18: 95. doi:10.1007/s10741-012-9333-z


Aerobic exercise training in the heart failure (HF) population is supported by an extensive body of literature. The clinically accepted model for exercise prescription is currently moderate-intensity-aerobic continuous training (MI-ACT). Documented benefits from the literature include improvements in various aspects of physiologic function, aerobic exercise capacity and quality of life while the impact on morbidity and mortality is promising but requires further investigation. Recently, however, a body of evidence has begun to emerge demonstrating high-intensity-aerobic interval training (HI-AIT) can be performed safely with impressive improvements in physiology, functional capacity and quality of life. These initial findings have led some to question the long-standing clinical approach to aerobic exercise training in patients with HF (i.e., MI-ACT), implying it should perhaps be replaced with a HI-AIT model. This is a potentially controversial paradigm shift given the potential increase in adverse event risk associated with exercising at higher intensities, particularly in the HF population where the likelihood of an untoward episode is already at a heightened state relative to the apparently healthy population. The present review therefore addresses key issues related to HI-AIT in the HF population and makes recommendations for future research and current clinical practice.


Rehabilitation Cardiac Exercise prescription Moderate intensity Continuous Safety 

Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  • Ross Arena
    • 1
    • 2
  • Jonathan Myers
    • 3
  • Daniel E. Forman
    • 4
  • Carl J. Lavie
    • 5
    • 6
  • Marco Guazzi
    • 7
  1. 1.Physical Therapy Program, Department of Orthopaedics and RehabilitationUniversity of New Mexico School of MedicineAlbuquerqueUSA
  2. 2.Division of Cardiology, Department of Internal MedicineUniversity of New Mexico School of MedicineAlbuquerqueUSA
  3. 3.Division of Cardiology, VA Palo Alto Healthcare SystemStanford UniversityPalo AltoUSA
  4. 4.Division of Cardiovascular MedicineBrigham and Women’s HospitalBostonUSA
  5. 5.Department of Cardiovascular Diseases, John Ochsner Heart and Vascular InstituteOchsner Clinical School, The University of Queensland School of MedicineNew OrleansUSA
  6. 6.Pennington Biomedical Research CenterLouisiana State University SystemBaton RougeUSA
  7. 7.Department of CardiologyI.R.C.C.S. Policlinico San DonatoMilanItaly

Personalised recommendations