Background: Behavior change is challenging following an acute cardiac event, and commonly, individuals are ambivalent. Aim: The objective of this study was to describe the experience of behavior change of survivors of an acute cardiac event. Method: Semistructured interviews were undertaken with 25 participants attending 3 cardiac rehabilitation programs. An inductive process of qualitative thematic analysis was used to analyze the transcripts. Results: Analysis revealed ambivalence to change, misconceptions, and confusion about terminology. Discrepancies between what participants felt they should be doing and what they actually were doing reflected their ambivalence. Further inconsistencies were reflected in participants' misunderstandings and confusion regarding disease processes and management of heart disease. Conclusions: These findings reflect the misconception and ambivalence regarding behavior change that individuals experience. Clinicians may require greater skills in detecting conflicting or ambivalent discourse to support patients through sustainable health behavior change. Copyright �� 2011 Lippincott Williams & Wilkins.