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Introduction: Cardiac rehabilitation (CR) is typically delivered in hospital-based classes and is recommended to help people reduce their risk of further cardiac events. However, many eligible people are not completing the programme. This study aimed to assess the feasibility of delivering a web-based CR intervention for those who decline/drop out from usual CR., Intervention: A web-based CR programme for 6 months, facilitated with remote support., Methods: Two-centre, randomised controlled feasibility trial. Patients were randomly allocated to web-based CR/usual care for 6 months. Data were collected to inform the design of a larger study: recruitment rates, quality of life (MacNew), exercise capacity (incremental shuttle walk test) and mood (Hospital Anxiety and Depression Scale). Feasibility of health utility collection was also evaluated., Results: 60 patients were randomised (90% male, mean age 62±9 years, 26% of those eligible). 82% completed all three assessment visits. 78% of the web group completed the programme. Quality of life improved in the web group by a clinically meaningful amount (0.5±1.1 units vs 0.2±0.7 units: control). Exercise capacity improved in both groups but mood did not change in either group. It was feasible to collect health utility data., Conclusions: It was feasible to recruit and retention to the end of the study was good. The web group reported important improvements in quality of life. This intervention has the opportunity to increase access to CR for patients who would otherwise not attend. Promising outcomes and recruitment suggest feasibility for a full-scale trial., Trial Registration Number: 10726798., Competing Interests: Competing interests: None declared.

Background: To evaluate the possible long-term effect of symptoms of depression on mortality risk among patients with congestive heart failure., Material/methods: Proportional hazard models were used to evaluate the effect of symptoms of depression on mortality among 119 clinically stable patients with symptomatic heart failure, recruited from an outpatient cardiology practice. Fifty-one deaths were registered during the six years of data collection, all from cardiac causes., Results: Symptom of depression were a significant predictor of mortality (relative risk per 1-point increase on the depression scale, 1.05, confidence interval, 1.00 to 1.08; p = 0.016), controlling for the confounding effects of the personality trait of neuroticism, heart failure severity (proANP), gender and age., Conclusions: Given the long-term effect of depressive symptomatology on CHF mortality found in the present study, health care professionals should identify patients who are at risk of suffering from depression as early as possible, and should try to provide appropriate treatment. There is a need among CHF patients for studies that seek to examine whether treatment of depression reduces the risk of mortality.