The integration of information and communication technology (ICT) has revolutionized healthcare delivery, making telemedicine a critical component of modern medical practice. Telemedicine uses ICT for virtual consultations, remote monitoring, and health education, enhancing access and quality of care, especially in underserved areas. In cardiology, telemedicine supports acute and chronic care, with AI playing a pivotal role. For chronic conditions like heart failure (HF), AI-supported telemonitoring and biotelemetry reduce cardiovascular mortality and hospital readmission rates. Wearable technology and AI algorithms capture and analyze health metrics, improving telemedicine’s efficacy. In atrial fibrillation (AF), AI-enhanced wearable devices improve early detection and management by accurately identifying irregular heartbeats and supporting remote diagnosis and treatment. For acute conditions like myocardial infarction, AI in telemedicine enhances early diagnosis and treatment by rapidly interpreting ECGs and other physiological data. AI models show diagnostic performance comparable to or exceeding human specialists, suggesting a valuable role in prehospital settings. Overall, AI improves telemedicine by enhancing diagnostic accuracy, real-time monitoring, and clinical decision-making, ultimately advancing patient outcomes in cardiovascular care. Further development and comprehensive studies are needed to establish long-term benefits and ensure safe, effective implementation.