Would you consider opting for beta blocker withdrawal to improve exercise capacity in patients with heart failure with preserved ejection fraction and chronotropic incompetence?

The short version of my answer is Yes, however, I will provide more insight into this:

When considering beta-blocker withdrawal to improve exercise capacity in patients with HFpEF and chronotropic incompetence, the evidence and guidelines are nuanced. A prospective, randomized, controlled trial "Preserve-HR", is specifically investigating the effect of beta-blocker withdrawal on functional capacity in this patient population. This indicates a recognized interest in understanding the potential benefits of beta-blocker withdrawal in improving exercise capacity among patients with HFpEF and chronotropic incompetence (Palau et al., PMID 32073676).

Chronotropic incompetence, the inability to appropriately increase heart rate during exercise, limi...

Yes

I have had patient feel better significantly after beta blocker withdrawal and unless absolutely necessary, I avoid beta blockers on patients with HFpEF.