Patients living outside of urban centres do not have access to the same level of care as patients in cities. The use of the Internet has been suggested as a possible resolution to this geographic inequity. To identify the determinants of Internet use in patients with cardiovascular disease and the patterns of use. Cardiac inpatients of an urban tertiary and a northern regional hospital in British Columbia were invited to participate. Patients who could not speak English or who had mental impairment were excluded. Consenting patients were interviewed regarding demographics and home Internet use. A total of 294 patients participated. The mean (+/- SD) age was 64.0+/-12.7 years. Most participants were men (68%) of European ancestry (77%) with some postsecondary education (57%). All geographical regions of British Columbia were represented. A total of 66% of patients had home Internet access. In rural areas, 47% of patients had access to the Internet (P=0.020 compared with nonrural areas). Eighty-four per cent of patients with Internet access had a high-speed connection, 55% reported using the Internet daily and 23% used it more than once per week. Accessing health information from the Internet was reported by 70% of patients. These data indicate a high prevalence of Internet use among English-speaking cardiac patients and a strong desire to obtain health information using the Internet. Health care organizations can take advantage of the Internet to develop and evaluate the delivery of cardiac services to patients in their homes, particularly to patients in rural and remote communities.