, Volume 99, Issue 12, pp 853-855
Date: 07 Sep 2010

Use of ivabradine in catecholamine-induced tachycardia after high-risk cardiac surgery

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Sirs:

Low cardiac output syndrome commonly occurs after cardiac surgery with cardiopulmonary bypass (CPB) and often requires inotropic support to achieve an adequate hemodynamic status. The use of β-receptor stimulating substances is often needed in cardiac surgical patients to treat myocardial pump failure and subsequently prevent low output syndrome [1]. However, increased β-adrenergic stimulation may be associated with increased heart rate, myocardial oxygen consumption and incidence of dysrhythmias, especially in ischemic tissues or during reperfusion [2].

Ivabradine is a new molecule that specifically inhibits the funny current channels (If) in the sinoatrial node and reduces heart rate, without affecting other aspects of cardiac function [3]. In patients with stable coronary artery disease and left-ventricular systolic dysfunction, ivabradine reduced the incidence of admission to hospital for fatal and non-fatal myocardial infarction and coronary revascularization in a subgroup of