Telemonitoring in Heart Failure: A Review of Monitoring Techniques and Clinical Outcomes

Heart failure (HF) remains a significant cause of global morbidity and mortality, as well as a major contributor to healthcare expenditure, primarily due to frequent disease exacerbations and high rates of hospital readmissions. The increasing burden of chronic HF, alongside the limitations of traditional outpatient follow-up, has intensified interest in telemonitoring as a means of supporting the early detection of clinical deterioration and optimising long-term management. This narrative review evaluates the current evidence on telemonitoring for HF, focusing particularly on available technologies, clinical effectiveness, implementation barriers and priorities for future research. Open-access literature indexed in PubMed was reviewed, including randomised controlled trials, systematic reviews and meta-analyses involving adult patients with HF. Both invasive and non-invasive monitoring approaches, as well as mobile-based solutions and integrated, multidisciplinary care models, were considered. Overall, most studies suggest that telemonitoring interventions are linked to fewer HF-related hospitalisations, particularly when combined with structured clinical feedback and prompt therapeutic adjustments. However, evidence for an effect on all-cause mortality remains inconsistent. More favourable outcomes are observed in programmes that include an active clinical response, rather than passive data collection alone. Substantial variability in study design, patient populations, monitoring intensity and outcome measures contributes to the inconsistency in reported effectiveness. Although emerging technologies such as mobile health applications and implantable monitoring devices show promise, their implementation in the real world is often hindered by issues relating to patient adherence, costs, digital literacy and the absence of standardised protocols. Telemonitoring is a valuable addition to HF management, particularly for reducing hospital admissions and enabling early intervention. Its long-term effectiveness hinges on selecting the right patients, choosing the right monitoring method, and integrating it into multidisciplinary care pathways. Future research should prioritise protocol standardisation, cost-effectiveness evaluation, and the inclusion of underrepresented patient groups, in order to better define the role of telemonitoring in routine HF care.