High-intensity interval training in rehabilitation of patients after myocardial infarction: a rapid review of randomized trials

Introduction:
The debate surrounding the use of high-intensity interval training (HIIT) in cardiac rehabilitation (CR) for patients who have survived myocardial infarction (MI) is ongoing due to concerns regarding safety and long-term efficacy.

Aim:
This review presents an overview of the safety, effectiveness, and clinical applicability of HIIT compared to other training methods used in CR after MI.

Methods:
This rapid systematic review included randomized controlled trials published until January 20, 2025, in PubMed and Web of Science. Eligible studies used a HIIT protocol, involved adults (≥ 18 years) with a history of MI who participated in a HIIT or other (control) training program, and reported physiological and psychological outcomes.

Results:
Sixteen studies with 597 participants (n HIIT = 307; n comparison groups = 290) met the inclusion criteria. In most of the included studies HIIT interventions were associated with better improvements in quality of life, cardiorespiratory fitness, endothelial function, echocardiographic parameters, and serum biomarker levels compared to moderate-intensity exercises. However, early post-MI application was associated with fewer beneficial outcomes.

Conclusions:
HIIT may be an efficient and time-saving approach for CR, particularly in highly motivated and stable cardiovascular patients. HIIT protocols must be tailored by clinicians and progressively intensified based on tolerance and recovery. Future research should focus on optimizing HIIT protocols and determining their long-term safety and compliance.