The Living Guidelines: Initial Clinical Assessment of Patients Presenting with Heart Failure. Suggest Revisions to the CLASS III Guidelines

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Class III Guidelines
1. Endomyocardial biopsy should not be performed in the routine evaluation of patients with HF. (Level of Evidence: C)

2. Routine use of signal-averaged electrocardiography is not recommended for the evaluation of patients presenting with HF. (Level of Evidence: C)

3. Routine measurement of circulating levels of neurohormones (e.g., norepinephrine or endothelin) is not recommended for patients presenting with HF. (Level of Evidence: C)