Question

A 68-year-old with HFrEF (EF 20%) has resting HR 82 bpm in sinus rhythm despite maximally tolerated beta-blocker, ARNI, MRA, and SGLT2 inhibitor. BP 110/70. Persistent NYHA II. Next step?

Accepted Answer

Consider ivabradine if sinus rhythm HR ≥70 despite beta-blocker

Answer

Start non-DHP calcium channel blocker

Answer

Start amiodarone for rate control

Answer

Stop beta-blocker to increase BP

Answer

Add hydralazine alone

Practice question

A 68-year-old with HFrEF (EF 20%) has resting HR 82 bpm in sinus rhythm despite maximally tolerated beta-blocker, ARNI, MRA, and SGLT2 inhibitor. BP 110/70. Persistent NYHA II. Next step?