Treatment of chronic heart failure

Treatment

• ACE or Angiotensin II receptor antagonists (sartans) if ACE not tolerated.
• Sacubitril+valsartan.
• ß-blockers.
• Anticoagulation only if atrial fibrillation, mural thrombus or history of thromboembolism event.

Persistance of symptoms

• Sacubitril+valsartan (Entresto).
• Eplerenone (Inspra).
• Ivabradine (Procoralan).
• Digoxin (Digoxine).
• Cardiac resynchronization therapy (CRT).

Indications for cardiac resynchronization therapy

• QRS duration > 120 ms and ejection fraction < 35 %.
• If CRT already implanted and no amelioration consider heart transplantation.