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BACKGROUND Heart transplant patients (HTx) are expected to perform self- management behaviors to maximize transplant-related health outcomes. Using mobile health(m-Health) care applications could support disease self-management. Prior studies showed that mHealth information needs for HTx self-management were identified through: medical care related reminders, laboratory querying, experience sharing, diet and nutrition, and expert counseling. OBJECTIVE The aims of this study were to develop the mobile application for HTx (iHeart App) in Taiwan and to evaluate the usability through mixed method approaches: Technology Acceptance Model of Mobile Services (TAMM), positive and negative feedback, and using record analysis. METHODS The prospective study with two cross-sectional surveys (base line, first month after iHeart App use) was conducted from April to July, 2019. Post HTx patients were enrolled from the HTx specific clinic area in one regional hospital in northern Taiwan. The TAMM with six perceived factors (values, ease of use, adoption, trust, intention to use, taking into use), pros and cons questionnaires were used to collect the subjective data toward iHeart App. After one year, then using records from administering medication, blood pressure, and symptoms the data was retrieved from the log database of iHeart App. Correlation, regression and content analysis were used for statistics. RESULTS A total of 53 eligible patients participated, with a mean age of 48.9 years (SD=11.67); the average transplant time was 9.2 years (SD=6.93); mostly male (n=46, 86.8%); and with a high school degree (n=19, 35.8%). The mean difference between the baseline and first month were less than 0.6 (p≦ .001) in six perceived factors of TAMM. The number of positive feedback was more than the negative feedback (85 vs. 57) and mostly on perceived ease of use (42). The average records per month on administering medication, blood pressure, and symptoms were 513, 185, and 3, respectively after using iHeart App for one year. Higher numbers of self-recording during the first month, higher total after one year of administering medication, (r=.83, p<.00) and blood pressure (r=.48, p<.00). During the first three months using records could predict the one-year usage of iHeart App with administering medication (R2=.85, F=93.9, p=.00), blood pressure (R2=.96, F=388.8, p=.00), and symptoms recording (R2=.97, F=625.8, p=.00). CONCLUSIONS The study showed that patients with HTx accepted iHeart App as the supportive technology to facilitate their self-management. The negative feedback provided useful information to optimize the App on the communication with the health care professional team. Further studies on the long-term HTx related survival outcomes were recommended.