Duration of exercise should include an adequate warm-up period, with this period being longer in the most debilitated patients. Most studies have used 3 to 5 times/wk as the optimal training frequency.335 The need for monitor- ing has not been systematically studied, but telemetry monitoring is recommended initially.337 Home training can follow this early supervised period for patients not demonstrating any hemodynamic or rhythm instability. It would be prudent, however, to monitor patients who have demonstrated exercise-induced arrhythmias and those patients with advanced HF.335 Although the safety and efficacy of resistance train- ing have not been established in this population,335 re- sistance training can offer the opportunity to strengthen individual muscle groups and has been shown to be ef- fective without safety issues in small trials with patients Small free weights (1, 2, or 5 lb), elas- tic bands, or repetitive isolated muscle training can be but the safety of resistance training in patients with HF needs to be further established in larger trials.335 Recommendations Harmonized With Existing Guidelines See Tables 13 and 14 for a summary of these recom- mendations. 