The autonomic nervous system marks beneficial drug responses in systolic heart failure management. The impact of statin therapy in this broad disease class is unclear and patient studies are extremely limited. METHODS: We studied a group of 23 patients with stable systolic ventricular impairment and randomised them single (patient) blind to high dose Atorvastatin 40 mg daily or placebo in addition to standard therapies over a 12-week treatment interval. Impact on the autonomic nervous system was assessed by anonymised short-term (20 min) standardised supine heart rate variability analyses. RESULTS: Two subjects withdrew one due to decompensation and one due to gastric intolerance. The remaining subjects completed both monitoring events without changes in standard medicines. Frequency domain but not time domain HRV indices improved with active statin therapy suggesting beneficial effects in attenuating sympathetic tone. CONCLUSIONS: In this small study we saw short-term high potency statin treatment had a beneficial impact on frequency domain HRV measures suggestive of an impact on sympatho-activation. We found no effect on time domain HRV indices. This may suggest a lesser or no effect on parasympathetic tone.