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Background Virtual wards are a novel space for continuing patient care by transitioning from hospital to home. University Hospital Limerick (UHL) is one of two pilot sites in Ireland treating patients on virtual wards. Patients with decompensated heart failure can be transferred to virtual ward to continue their care at home.Aims STRONG HF showed benefit in rapidly uptitrating medical therapies for heart failure. Our aim was to audit the safety and efficacy of the virtual ward at UHL in implementing rapid medication up-titration.Methods This was a retrospective study. We reviewed all patients following hospital admission with decompensated heart failure (ADHF), transfered to VW over 6 months from 1/7/24 to 31/12/24 with EF<40%. We then reviewed medications at first heart failure clinic post-discharge from the virtual ward and nt-proBNP levels at hospital admission, discharge and follow-up.Results 105 patients were identified. 32 had EF<40%. 5 patients were followed up outside of UHL. 27 patients were included ( table 1), mean LVEF was 25%±6. At first follow-up in HF OP, 26 patients were on RASI (96%) with 12 on ARNI (46%). 93% of patients were on beta blocker. 74% were on MRA, 74% on SGLT2i. 6 patients were readmitted to hospital from VW. The median NT pro BNP on admission was 6537 ng/l with a significant reduction to 2713 ng/l at discharge. (p=0.026). There was a further significant reduction to 1944 ng/l at first clinic follow up review (p=0.02) (figure 1).Conclusion Patients with new diagnosis of HFREF followed up in a UHL heart failure clinic after discharge from VW were on excellent GDMT, In keeping with this the NT pro BNP significantly reduced at discharge from the VW and remained significantly reduced at follow up. This new way of treating patients after an admission with ADHF shows potential benefit of VWs for rapid uptitration of GDMT.Abstract 74 Table 1Abstract 74 Figure 1