ABSTRACT
Heart failure (HF) is a syndrome of breathlessness and fatigue in the presence of impaired emptying or filling of the heart. HF is a term used to describe the syndrome that arises due to inadequate cardiac output resulting from progressive impairment of heart function. In clinical practice, the severity of HF is classified according to the burden of symptoms patients' experience using the New York Heart Association classification. Sympathetic stimulation increases heart rate and contractility, initially improving cardiac output but ultimately increasing the heart's metabolic requirements and predisposing to fatal arrhythmias. Beta-blockers counteract sympathetic activation, reduce heart rate and contractility, and, largely by their effect on sympathetic activation and reverse remodeling, reduce the risks of dysrhythmia and sudden cardiac death. Significant left ventricular dysfunction, particular secondary to ischemic heart disease. Left ventricular assist devices are increasingly offered to patients with refractory HF not responding to contemporary therapies.
