A pilot trial to assess the safety of withdrawing heart failure (HF) treatment in patients deemed to have recovered from dilated cardiomyopathy shows that around 40% have a relapse within 6 months of treatment withdrawal. Patients with previous dilated cardiomyopathy and clinical, imaging and biochemical evidence of recovery were randomly assigned to phased withdrawal (n = 25) or treatment continuation (n = 26). In the first 6 months, 11 patients assigned to phased withdrawal had a relapse of dilated cardiomyopathy compared with none in the continued treatment group. After 6 months, patients initially assigned to continue treatment had the treatment withdrawn, and in the following 6 months, nine patients had a relapse. According to the investigators, these findings suggest that for many patients, improved cardiac function reflects remission rather than permanent recovery, and caution that until robust variables to discriminate remission from recovery are identified, treatment should continue indefinitely.