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W hen beta-adrenergic blocking agents were put on thepharmacological market about 40 years ago, these drugs were considered to be contraindicated in patients with heart failure. Sympathetic stimulation was thought to be profitable for a failing heart. It was concluded that negative inotropic and chronotropic effects of beta-blocking agents worsen the course of this disease. However, concepts in pathophysiology of heart failure have changed. Obviously, chronic activation of the sympa-thetic nervous system damages the myocardium. Moreover, clinical trials have shown that beta-blocking drugs can reduce mortality in patients after myocardial infarction and with symptomatic chronic heart failure. Definition, Epidemiology and Prognosis of Heart Failure Heart failure is quite difficult to define. This syndrome show