Prescribe diuretics, digoxin and nitrates for
people already using ACEIs and beta-blockers to
manage symptoms as indicated.
• Consider prescribing fish oils for people with
symptomatic systolic HF after ACEIs and betablockers.
• For people who have severe systolic heart failure
(New York Heart Association (NYHA) Class
III-IV) despite appropriate doses of ACEIs and
diuretics, consider prescribing spironolactone.
• Consider prescribing eplerenone for people with
systolic heart failure who still have mild (NYHA
Class II) symptoms despite receiving standard
therapies with ACEIs and beta-blockers.
• Consider direct sinus node inhibition with
ivabradine for people with CHF who have
impaired systolic function, have had a recent
heart failure hospitalisation and are in sinus
rhythm with a heart rate > 70 bpm.
• Consider assessing people with CHF for
biventricular pacemakers and implantable
defibrillators.