Prognosis of chronic heart failure has improved but remains severe. Modern disease management for ambulatory patients includes telemedical approaches, which have shown positive effects on morbidity and mortality both for device-assisted monitoring and for nurse telephone support. Current technology is feasible for comfortable and extensive real-time transmission of patient data. Daily monitoring of symptoms, vital signs, and information from cardiac implants should enable the health care specialist to detect early worsening of the disease and initiate treatment. Appropriate clinical application of telemedicine to the individual patient and local health care structure is a challenge.