ABSTRACT
Heart failure is a clinical syndrome comprising reduced cardiac output, tissue hypoperfusion and congestion resulting in breathlessness, fatigue and ankle oedema. Heart failure is common and disabling. It has high mortality rate and poor prognosis if not treated aggressively. Despite advances in management, patients with heart failure are still associated with a high mortality rate, 30% at one year and 60-70% after five years. Heart failure is physically and emotionally disabling and has a major impact on quality of life. The term heart failure can cause extreme anxiety to the patient and their carer. The prevalence of depression in heart failure is between 13% and 77%. Heart failure is associated with poor quality of life and frequent admissions to hospital. The benefits of beta blockers on mortality, symptoms and hospitalisation rates in heart failure are well established. Reduction of heart rate with Ivabradine results in the improvement of clinical outcomes in heart failure.
