Slowing Heart Rate with Ivabradine: Good, But Not Good Enough

In patients with CAD and LV dysfunction, I_f-channel blockage reduced ischemia-related symptoms but had no effect on mortality.

A high resting heart rate is an independent predictor of all-cause and cardiovascular mortality. Agents that lower heart rate, such as β-blockers and non-dihydropyridine calcium-channel blockers, have additional cardiovascular effects that confound attempts to study this association in patients with cardiovascular disease. Might the addition of ivabradine — an I_f-channel blocker that slows sinus-node pacemaker function — to standard therapy reduce the risk for cardiovascular death in such patients?

In this manufacturer-funded, randomized, double-blind, international trial, investigators enrolled 10,917 patients in sinus rhythm who had coronary artery disease and LV dysfunction (82% men; mean age, 65; mean LV ejection fraction, 32%; mean base…

Reviewing Author

Beat J. Meyer, MD

Disclosures

Leadership positions in professional societiesBern Heart Foundation (President); International Academy of Medicine, Bern, Switzerland (Director)

Beat J. Meyer, MD

Disclosures

Leadership positions in professional societiesBern Heart Foundation (President); International Academy of Medicine, Bern, Switzerland (Director)