Long-term noninvasive ventilatory support (NIV) is increasingly recognized as a critical intervention for managing chronic cardiac disorders, particularly in patients with chronic hypercapnic respiratory failure. Evidence suggests that long-term NIV can improve clinical outcomes, including reductions in mortality and hospitalizations, while enhancing health-related quality of life (HRQoL). NIV mitigates the work of breathing, decreases systemic inflammation, and promotes cardiac function by reducing neurohormonal activation and improving gas exchange. However, the extent of these benefits varies based on patient adherence, device settings, and the management of comorbidities such as obesity and sleep apnea. Predictive models for long-term NIV success emphasize adherence as a key determinant of mortality and morbidity. Multidisciplinary care integrating pulmonologists, cardiologists, and physiotherapists is essential for optimizing outcomes, particularly in transitioning patients from hospital to home settings. This chapter aims to provide a comprehensive overview of the long-term outcomes and quality of life implications associated with NIV in chronic cardiac disorders. It examines clinical evidence, discusses patient-centered outcomes, and explores the integration of multidisciplinary care to optimize NIV effectiveness.