A government target set seven years ago to provide follow-up care for heart attack victims has still not been met.
Only 34% of heart attack sufferers go on to take part in a cardiac rehabilitation programme, according to a national British Heart Foundation (BHF) audit of 83,540 patients.
Heart attack sufferers use the programme to help cope with the physical and emotional consequences of having a heart attack.
In the programme patients work with nurses and physiotherapists discussing issues such as diet and exercise in groups or one-to-one.
The government's National Service Framework for Coronary Heart Disease aimed for 85% of heart patients to be referred to a cardiac rehabilitation programme by 2002.
Published in the National Audit of Cardiac Rehabilitation, the new figures suggest this target is not being met seven years on.
In 2007/08, just 34% of heart attack sufferers, 30% of angioplasty patients and 68% of those who have had a coronary artery bypass operation, were enrolled on a cardiac rehabilitation programme.
Dr Mike Knapton, associate medical director at the BHF, said: "Referral to cardiac rehabilitation should be a routine part of treating heart patients, and until this happens they will continue to miss out."