ACE and heart failure: The current ESC heart failure guidelines for heart failure therefore recommend heart rate reduction with the If channel blocker ivabradine for symptomatic patients with chronic systolic heart failure in sinus rhythm and a heart rate of ≥ 70 bpm as an adjunct therapeutic strategy after establishment of a treatment with a maximum tolerated dose of beta-blockers, ACE-I (or ARB) and a MRA [13].