35
7.3.9.1. Management of Stage C HF: Ivabradine
COR LOE
Recommendation
2a B-R 1. For patients with symptomatic (NYHA class II to III) stable
chronic HFrEF (LVEF ≤35%) who are receiving GDMT,
including a beta blocker at maximum tolerated dose, and
who are in sinus rhythm with a heart rate of ≥70 bpm at rest,
ivabradine can be beneficial to reduce HF hospitalizations and
cardiovascular death.
7.3.9. Additional Medical Therapies
7.3.9.2. Pharmacological Treatment for Stage C HFrEF
(Digoxin)
COR LOE
Recommendation
2b B-R 1. In patients with symptomatic HFrEF despite GDMT (or who
are unable to tolerate GDMT), digoxin might be considered
to decrease hospitalizations for HF.
7.3.9.3. Pharmacological Treatment for Stage C HFrEF:
Soluble Guanylyl Cyclase Stimulators
COR LOE
Recommendation
2b B-R 1. In selected high-risk patients with HFrEF and recent
worsening of HF already on GDMT, an oral soluble guanylate
cyclase stimulator (vericiguat) may be considered to reduce
HF hospitalization and cardiovascular death.
