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- Title
Clinical Experience with Ivabradine in Acute Heart Failure.
- Authors
Pascual Izco, Marina; Alonso Salinas, Gonzalo Luis; Sanmartín Fernández, Marcelo; Del Castillo Carnevalli, Hugo; Jiménez Mena, Manuel; Camino López, Asunción; Zamorano Gómez, José Luis
- Abstract
Objective: Ivabradine has been shown to improve symptoms and to reduce rehospitalization and mortality in patients with severe chronic heart failure (HF). Its indication in acute HF is not clear. Acute HF patients could also benefit from HR reduction, as myocardial consumption and oxida-tive stress are related to tachycardia. Moreover, beta-block-ers are contraindicated in cardiogenic shock and should not be initiated with congestive signs. Accordingly, we evaluated the role of ivabradine in acute HF patients. Methods:This was a retrospective analysis of 29 consecutive patients treated for acute HF in the Cardiac ICU, and for whom ivabradine was initiated during hospitalization between January 2011 and January 2014. All patients were in sinus rhythm and had a heart rate (HR) >70 bpm. Catecholamine use was necessary in 16 patients (57.1%) during the hospitalization, in 14 (87.5%) of these before ivabradine treatment. Results: Systolic blood pressure showed no variation during the first 24 h of ivabradine administration or at discharge. HR showed an absolute reduction of 10 bpm at 6 h (p < 0.001), 11 bpm at 24 h (p = 0.004) and 19 bpm (p < 0.001) at discharge. No episodes of significant bradycardia or hypotension were re corded after starting the drug. Conclusions: HR reduction with ivabradine in acute HF is well tolerated. It represents an attractive option, especially when there is excessive catecholamine-related tachycardia; this should be appropriately evaluated in randomized trials.
- Subjects
IVABRADINE; HEART failure; BRADYCARDIA; TACHYCARDIA; THERAPEUTICS; HEART diseases
- Publication
Cardiology, 2016, Vol 134, Issue 3, p372
- ISSN
0008-6312
- Publication type
Article
- DOI
10.1159/000444845