2026 ESC Guidelines for the management of heart failure

Publication Date: August 2026
Chairpersons: Lars Køber and Marianna Adamo

Table of Contents 

• Introduction
• Definition, epidemiology, and classifications
  • Definition of HF
  • ClassificationPrevention of HF
• Prevention of HF
• Diagnosis of chronic HF
  • Key steps in the diagnosis of chronic HF
  • HF phenotypes based on left ventricular ejection fraction
    • Heart failure with reduced ejection fraction
    • Heart failure with preserved ejection fraction
  • Aetiology and subtypes of HF
• Management of chronic HF
  • Guideline-directed medical therapy for HF
  • Guideline-directed interventional therapies for chronic HF
    • Implantable cardioverter-defibrillators
    • Cardiac resynchronization therapy
• Decompensated HF
  • Diagnosis
  • Clinical presentation
  • General management
  • Treatment
• Decongestion management
• Temporary mechanical circulatory support
• Advanced HF
  • Epidemiology, definition, prognosis, and referral
  • Management
    • Pharmacological therapy and kidney replacement therapy
    • Mechanical circulatory support
    • Heart transplantation
• Cardiovascular comorbidities
  • Arrhythmias and conduction disturbances
  • Chronic coronary syndromes
  • Valvular heart disease
  • Non-cardiovascular comorbidities
  • Obesity
  • Diabetes
  • Chronic Kidney Disease
  • Iron deficiency and anaemia
  • Cancer
  • Lung disease and sleep-disordered breathing
  • Anxiety, depression and frailty
  • Other non-cardiovascular comorbidities
• Multidisciplinary team management, long-term follow-up, and patient care
  • Exercise training and cardiac rehabilitation
  • Telemonitoring
• Long-term follow-up
• Specific conditions
  • Pregnancy and HF
  • Amyloidosis