Key summary pointsAimTo explore barriers and facilitators regarding dietary intake and physical activity behaviour change in older patients undergoing transcatheter aortic valve implantation.FindingsThree following themes were identified as barriers: (1) low physical capability, (2) healthy dietary intake and physical activity are not a priority at an older age and (3) ingrained habits and preferences. Three themes were identified as facilitators: (1) knowledge that dietary intake and physical activity are important for maintaining health, (2) norms set by family, friends and caregivers and (3) support from the social environment.MessageGiven the prevalent ambivalence among older cardiac patients towards behaviour change, healthcare professionals should address this mindset before implementing interventions to promote behaviour modification.Supplementary InformationThe online version contains supplementary material available at 10.1007/s41999-023-00774-1.