Telerehabilitation in heart failure patients: The evidence and the pitfalls

•According to current ESC guidelines, cardiac rehabilitation is now recommended as an important component of a comprehensive approach to heart failure patients.•Unfortunately, the accessibility and adherence to traditional forms of cardiac rehabilitation programs in heart failure patients remain unsatisfactory.•Therefore, a home-based telerehabilitation model has been proposed as a new promising option.•This paper's aims are to present and discuss the available tools of telemonitoring in terms of their characteristics, applicability, and effectiveness in providing the best long term management and telesupervised rehabilitation for heart failure patients.

Accessibility to the available traditional forms of cardiac rehabilitation programs in heart failure patients is not adequate and adherence to the programs remains unsatisfactory. The home-based telerehabilitation model has been proposed as a promising new option to improve this situation. This paper's aims are to discuss the tools available for telemonitoring, and describing their characteristics, applicability, and effectiveness in providing optimal long term management for heart failure patients who are unable to attend traditional cardiac rehabilitation programs. The critical issues of psychological support and adherence to the telerehabilitation programs are outlined. The advantages and limitations of this long term management modality are presented and compared with alternatives. Finally, the importance of further research, multicenter studies of telerehabilitation for heart failure patients and the technological development needs are outlined, in particular interactive remotely controlled intelligent telemedicine systems with increased inter-device compatibility.