All are true about starting of beta-blocker therapy in a patient with congestive heart failure except:
High-Yield Explanation
Clinical use of β2 adrenergic receptor antagonists in heart failure
These are now recommended for routine use in patients with an ejection fraction < 35% and NYHA class II or III symptoms in conjunction with ACE inhibitor or angiotensin-receptor antagonist, and diuretics.
These should be initiated at very low doses, generally less than one-tenth of the final target dose.
NYHA Class IIIB and IV patients should be approached with a high level of caution; and in recently decompensated heart failure, beta-blockers should not be used until the patients are stabilized for several days to weeks.