Is 'fast tracking' to Phase IV as effective as standard cardiac rehabilitation?

To the Editor:
The recent study by Robinson et al. investigates a potential solution to the gap that currently exists between evidence and practice in relation to cardiac rehabilitation. As the authors point out, uptake of cardiac rehabilitation consistently falls short of the recommendation that the majority of those at risk of a future cardiac event should attend a formal secondary prevention program. Various systematic reviews and individual studies have investigated different approaches for the delivery of cardiac rehabilitation that could help address this evidence-practice gap. We commend Robinson et al. for investigating another approach with great potential to reduce the gap. We also commend their strong trial design which scores 8/10 on the PEDro Scale due to the inclusion of features such as intention-to-treat analysis, assessor blinding, excellent follow-up and concealed allocation.