VWCR to Improve Cardiovascular Health and Outcomes Among Cardiac Patients: A Multicenter Randomized Clinical Trial Protocol (Destination Cardiac Rehab Study)

The purpose of this research is to compare health outcomes and participation between a virtual world cardiac rehabilitation (Destination Cardiac Rehab) program and the standard of care Center-based Cardiac Rehabilitation program. Destination Cardiac Rehab, developed with input from patients with heart disease and their caregivers, is a 3-D, interactive program offering an affordable telehealth option for cardiac rehabilitation (cardiac rehab) that can be done from home or any place that you can access the Internet with a computer.

Inclusion Criteria: * Indication for CR according to Centers for Medicare \& Medicaid Services (CMS) guidelines: * Myocardial infarction within the preceding 12 months * Coronary artery bypass surgery * Current stable angina (chest pain) * Heart valve repair or replacement * Percutaneous transluminal coronary angioplasty (PTCA) or coronary stenting * Heart or heart-lung transplant * Stable chronic heart failure * Aged ≥18 years * Basic Internet navigation skills * Active email address Exclusion Criteria: * High risk patients according to the American Association of Cardiovascular and Pulmonary Rehabilitation (AACVPR) risk stratification103 given safety concern of unsupervised exercise: * Sudden cardiac arrest survivor * Receiving continuous inotropic support * Presence of a mechanical circulatory support device * Decompensated heart failure * Symptomatic valvular heart disease * Uncontrolled angina * Presence of hemodynamically unstable dysrhythmias (e.g., ventricular tachycardia) * Pregnant (due to associated hormonal and weight changes) * Non-English-speaking * Visual/hearing impairment or mental disability that would preclude independent use of the VW platform