34 of As a result of new evidence the treatment pathway for heart failure with reduced ejection fraction in recommendation 1.4.26 has been amended. Second line treatment has been replaced by specialist treatment. A sentence has been added to clarify that specialist advice should be sought before starting treatment with digoxin. The first part of recommendation 1.6.2 has been removed because it is now covered in section 1.1 on team working in the management of heart failure. Amlodipine to treat hypertension has been deleted from recommendation 1.6.3 because it has been superseded by the NICE guideline on hypertension in adults. 'Regularly' has been replaced by 'at the 6-monthly clinical review' in recommendation 1.6.5 for clarification. The wording in recommendation 1.6.6 has been amended in line with recommendation 1.6.5. Minor changes since publication April 2022: In section 1.4 we added links to NICE's technology appraisal guidance on dapagliflozin and empagliflozin for treating chronic heart failure with reduced ejection fraction. November 2021: We added a link to the NICE guideline on heart valve disease in recommendations 1.2.8, 1.2.15 and 1.4.2. 35 of Accreditation 36 of