The present systematic review shows that aerobic trainingincreases heart rate recovery in patients with established heartdisease. Of the eight eligible studies found in our systematicreview, five met the criteria for methodological quality and threemet the requirements for therapeutic validity. Only two studiesshowed both a low risk of bias and a high therapeutic validity.Both studies showed a significant improvement of HRR afterexercise training compared to no training. Although only twoout of the eight eligible studies met the predetermined criteriaand the total number of patients is limited, they showed ahomogenic conclusion. On this basis we conclude that thepresent systematic review shows a level 1A evidence thataerobic training increases heart rate recovery in patients withestablished heart disease.