Chronic Cardiac Failure

Management

Mortality

The following improve mortality:
ACE inhibitors (SAVE, SOLVD, CONSENSUS)
Beta-blockers (CIBIS)
spironolactone (RALES)
hydralazine with nitrates (VHEFT-1)

Symptomatic benefit

Diuretics to offload excess fluid
Ivabradine (contraindicated in AF)

Co-existent AF

Digoxin - no effect on mortality, but useful for controlling AF and positive inotropic effects.

Other

Seasonal influenza vaccine
Pneumococcal vaccine