Ivabradine in Management of Heart Failure: a Critical Appraisal

• Published in: Current heart failure reports 2016-02, Vol.13 (1), p.60-69
• Main Authors: Orasanu, Gabriela, Al-Kindi, Sadeer G., Oliveira, Guilherme H.
• Format: Article
• Language: English
• Subjects: Arrhythmias, Cardiac - drug therapy; Benzazepines - pharmacology; Benzazepines - therapeutic use; Cardiac Surgery; Cardiology; Cardiomyopathies - drug therapy; Cardiovascular Agents - pharmacology; Cardiovascular Agents - therapeutic use; Clinical Studies as Topic; Heart Failure - diagnostic imaging; Heart Failure - drug therapy; Heart Failure - physiopathology; Heart Rate - drug effects; Heart Transplantation; Humans; Imaging; Internal Medicine; Medicine; Medicine & Public Health; Pharmacologic Therapy (W H W Tang; Radiology; Section Editor; Shock, Cardiogenic - drug therapy; Topical Collection on Pharmacologic Therapy; Ultrasonography; Vascular Surgery
• ISSN: 1546-9530; 1546-9549
• DOI: 10.1007/s11897-016-0276-x

Elevated resting heart rate has been linked to poor outcomes in patients with chronic systolic heart failure. Blockade of funny current channel with ivabradine reduces heart rate without inotropic effects. Ivabradine was recently approved by US Food and Drug Administration for patients with stable, symptomatic chronic heart failure (HF) with left ventricular ejection fraction (LVEF) ≤35 %, who are in sinus rhythm with resting heart rate (HR) ≥ 70 bpm and either are on maximally tolerated doses of beta-blockers, or have a contraindication to beta-blockers. This article will review and evaluate the data supporting the use of ivabradine in patients with HF and explore its mechanisms and physiologic effects.