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Treatment of inappropriate sinus tachycardia with ivabradine

Abstract

Background

Inappropriate sinus tachycardia (IST) often causes palpitations, dyspnea, and exercise intolerance, that are generally treated with beta blockers and non-dihydropyridine calcium-channel antagonists. Ivabradine, a selective inhibitor of cardiac pacemaker If current, has recently emerged as an effective and safe alternative to conventional drugs for IST.

Methods

We performed a systematic overview of clinical studies on the therapeutic yield of ivabradine in patients with inappropriate sinus tachycardia, published in MEDLINE database from January 2000 to March 2015.

Results

Overall, five case reports were found, all showing efficacy of ivabradine in subjects affected by IST. Eight non-randomized clinical studies demonstrated short- and medium-term safety and efficacy of ivabradine administration in IST, also in adjunction to or in comparison with metoprolol. One double-blind randomized crossover study also showed that ivabradine is superior to placebo for heart rate (HR) reduction and symptoms control in patients affected by IST.

Conclusions

Ivabradine is effective and safe in short- and medium-term treatment of IST. However, long-term follow-up studies and randomized studies comparing ivabradine with beta blockers are still lacking.

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Abbreviations

Bpm:

Beats per minute

CCA:

Calcium-channel antagonists

EF:

Ejection fraction

HF:

Heart failure

HR:

Heart rate

IST:

Inappropriate sinus tachycardia

LV:

Left ventricular

METS:

Metabolic equivalents

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Correspondence to Leonardo Calo.

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The authors declare that they have no competing interests.

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Annamaria, M., Lupo, P.P., Foresti, S. et al. Treatment of inappropriate sinus tachycardia with ivabradine. J Interv Card Electrophysiol 46, 47–53 (2016). https://doi.org/10.1007/s10840-015-0066-5

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Keywords

  • Ivabradine
  • Inappropriate sinus tachycardia
  • Tachy-cardiomyopathy