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6 Management of chronic heart

failure

6.1 Guideline-directed medical therapy for

heart failure The Task Force have decided to introduce the terms FMT and AMT, as described in Section 3 (Figure 3). Together FMT and AMT cover GDMT. For HFrEF, FMT currently includes beta-blockers, ACE-Is/ARNIs/ARBs, MRAs, and SGLT2-Is, whereas for HFpEF it includes SGLT2-Is and MRAs. Importantly, AMT and GDIT based on the underlying cause of HF, phenotypical characteristics, and comorbidities are discussed in other sections.

6.1.1 Goals of pharmacotherapy for patients with heart

failure Pharmacotherapy remains the cornerstone of treatment for stage C HF and should be implemented at doses used in RCTs in patients with HF before considering device therapy, and alongside non-pharmacological interventions (Figure 1 and Table 11). There are three major goals of treatment for patients with HF: (i) reduction in mortality; (ii) prevention of recurrent

Figure 9 Diagnosing arrhythmia-associated heart failure and heart failure with abnormal cardiac conduction. AF, atrial fibrillation; CIED, cardiac implantable electronic device; CMR, cardiac magnetic resonance; ECG, electrocardiogram; HFrEF, heart failure with reduced ejection fraction; LBBB, left bundle branch block; PET, positron emission tomography; PMT, pacemaker tachycardia; PVC, premature ventricular contraction; RBBB, right bundle branch block; RV, right ventricular; SVT, supraventricular tachycardia; VT, ventricular tachycardia; WHF, worsening heart failure. Downloaded from academic.oup.com/eurheartj/advance-article/doi/10.1093/eurheartj/ehag100/8766302 by guest on 31 August 2026