This was based on an evidence review conducted for the 2003 guideline, and the review was not updated in 2010. The new recommendation clarifies that coronary revascularisation should not be routinely offered to patients with HFREF without angina, but allows clinicians to use their professional judgement to consider whether coronary revascularisation may be appropriate for each patient on a case by case basis. The committee considered that the new recommendation would be unlikely to have a significant resource impact as they do not consider that it will change current practice. The 2003 CHF guideline made reference to 2 papers narratively regarding this review question. These studies have been excluded within the current review as they were carried out previous to 2001 when new guidance regarding the use of beta-blockers for the management of HF were introduced. The committee agreed that this change in management was likely to have had an effect on treatment strategies overall and therefore only wished to consider studies carried out after 2001. Chronic Heart Failure Treating Heart Failure NICE 2018. All rights reserved. Subject to Notice of rights. ISBN: 978-1-4731-3093-7 6.3.2 Recommendations for invasive procedures 6.3.2.1 Implantable cardioverter defibrillators and cardiac resynchronisation therapy See NICE s technology appraisal guidance on implantable cardioverter defibrillators and cardiac resynchronisation therapy for arrhythmias and heart failure 6.3.2.2 Coronary revascularisation 64.Do not routinely offer coronary revascularisation to people who have heart failure with reduced ejection fraction and coronary artery disease. [2018] 6.3.2.3 Cardiac transplantation 65.Specialist referral for transplantation should be considered for people with severe refractory symptoms or refractory cardiogenic shock [2003] Chronic Heart Failure Rehabilitation in chronic heart failure NICE 2018. All rights reserved. Subject to Notice of rights. 