BACKGROUND Patients with chronic heart failure (CHF) frequently complain of fatigue and exercise intolerance that are not directly related to the severity of cardiac failure. A not well-defined muscle function impairment is generally considered the cause of such symptoms. The frequency compression of electromyographic (EMG) signal power spectrum during isometric contractions is commonly accepted as an index of the fatigue occurring in the muscle (localized muscle fatigue). OBJECTIVE The purpose of the study was to evaluate muscle fatigue development in a selected group of CHF patients by studying the compression of the EMG signal power spectrum. The first dorsal interosseus of the right, dominant hand was investigated at two levels of contraction: 40% and 80% of the maximal voluntary contraction (MVC). RESULTS In CHF patients there was early development of localized muscle fatigue during the high level of contraction (80% of MVC). CONCLUSIONS This study demonstrates the presence of an early development of localized muscle fatigue in CHF patients and confirms the possibility of an increased glycolytic metabolism. Moreover, the changes seem to show that muscle impairment is not limited to large muscles, but also occurs in small muscles of the hands, frequently used during daily activities. Finally, this study confirms the validity of EMG spectral analysis techniques in evaluating muscle fatigue of CHF patients, suggesting a possible use in the rehabilitation of such patients when the technique is correctly used.