Impact of Telemonitoring on Hospitalization and Mortality Among Patients With Heart Failure: A Systematic Review of Randomized Controlled Trials

Heart failure (HF) is a chronic condition associated with high rates of hospitalization and mortality. Telemonitoring has emerged as a potential strategy to improve patient outcomes; however, its effectiveness remains uncertain. This systematic review evaluated randomized controlled trials (RCTs) comparing telemonitoring interventions with usual care in patients with HF. A literature search was conducted using PubMed and Google Scholar to identify relevant studies published between January 2010 and December 2025. The final literature search was performed in January 2026. Eligible studies included RCTs reporting hospitalization and/or mortality outcomes associated with telemonitoring interventions. A total of 12 RCTs were included. Telemonitoring interventions demonstrated substantial heterogeneity and included remote patient monitoring systems, implantable cardiac device-based monitoring, telerehabilitation, and remote-guided therapy optimization. Several studies demonstrated reduced hospitalization compared with usual care; however, most studies reported neutral hospitalization outcomes. Regarding mortality, only a limited number of studies reported benefit, whereas most studies demonstrated no clear difference compared with usual care. Overall, telemonitoring may provide supportive benefit in selected patients with HF, although findings remain heterogeneous and predominantly neutral, particularly regarding mortality outcomes. Further well-designed studies with standardized intervention strategies are needed to better define the patient populations most likely to benefit.