ArticleFrontiers in cardiovascular medicine2026
Case Report: Whole-body electrical muscle stimulation as an adjunctive tool in cardiac rehabilitation of a patient with heart failure and reduced ejection fraction.
Article in Frontiers in cardiovascular medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Whole-body electrical muscle stimulation (WB-EMS) is an emerging modality that simultaneously activates multiple large muscle groups via a wearable electrode suit. Although localized neuromuscular electrical stimulation (NMES) has demonstrated efficacy as an adjunctive strategy in cardiac rehabilitation (CR), WB-EMS has not previously been investigated in patients with heart failure and reduced ejection fraction (HFrEF) undergoing CR. Case description: A 73-year-old male with recurrent non-ST-elevation myocardial infarction (NSTEMI), chronic heart failure (LVEF 20%-25%), and New York Heart Association class III was admitted for a 24-day inpatient CR programme. Standard CR (cycle ergometry, treadmill, resistance exercises, respiratory physiotherapy, and education, five days/week) was augmented with WB-EMS (Wiems Revolution Pro; 85 Hz bipolar, 350 μs, 4 s on/4 s off, 20 min sessions) three times per week (ten sessions). Safety was monitored with serial creatine kinase (CK), high-sensitivity troponin I (hs-TnI), N-terminal pro-brain natriuretic peptide (NT-proBNP), C-reactive protein (CRP), and venous blood gas with lactate, measured before and 2-3 h after each session. Outcomes: A modest, age-appropriate improvement in functional capacity was accompanied by substantial reverse left-ventricular remodelling: LVEF improved from 27% to 54% (Simpson biplane); peak workload from 66 to 97 W (+47%); six-minute walk test distance from 390 to 590 m (+51%); peak oxygen uptake from 17.42 to 19.02 mL/min/kg (+9.2%); and EQ-5D-5L visual analogue scale from 60 to 90/100. Pre-exercise NT-proBNP fluctuated across the ten sessions (range 318.3-1,019.3 pg/mL); the final-day rise to 1,019.3 pg/mL likely reflected greater training effort on the last exercise day, supported by the concurrently highest post-session venous lactate of the programme (4.4 mmol/L; Discussion: To our knowledge, this is the first report of WB-EMS combined with standard CR in an HFrEF patient. Comprehensive serial biomarker monitoring confirmed a favorable safety profile. Improvements across functional, echocardiographic, and quality-of-life domains are promising but require confirmation in randomized trials, as multiple concurrent therapeutic interventions preclude causal attribution to WB-EMS alone.
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