Integrating Internet of Things into cardiac rehabilitation for heart failure: a review of emerging technologies

Heart failure (HF) is a prevalent and debilitating condition that significantly affects patients' quality of life and places a substantial burden on healthcare systems. In recent years, digital technologies have been increasingly explored in cardiac rehabilitation (CR), particularly through their integration within Internet of Things (IoT) ecosystems to support remote monitoring and personalized care. This review aimed to provide a focused overview of emerging digital technologies applicable to the rehabilitation of patients with HF, with emphasis on solutions compatible with IoT-based systems. A targeted literature search was conducted in PubMed, Scopus, Cochrane and Web of Science, including studies published between 2019 and 2024. Studies addressing digital technologies in HF rehabilitation. Following a structured selection process, 59 articles were included in the narrative synthesis. The findings indicate a growing body of literature investigating wearable physiological monitoring devices, telehealth-based CR programs, digital platforms, and smart sensors, many of which have been explored for integration within IoT infrastructures. These technologies have been associated with improved remote follow-up, patient engagement, and real-time physiological data collection outside traditional clinical settings. Emerging applications of artificial intelligence within IoT-enabled systems have also been examined to support clinical workflows and adaptive rehabilitation strategies. Despite increasing interest, challenges remain, including heterogeneity in study designs, usability concerns, data privacy and security issues, economic barriers, and limited large-scale clinical validation. Overall, this review suggests that IoT-enabled technologies represent a promising area of research in CR, warranting further investigation to support their sustainable integration into routine HF care.