Treatment of inappropriate sinus tachycardia with ivabradine
1Department of Cardiology, University Medical Center, Ljubljana, Slovenia. peter.rakovec@kclj.si
Background:
Inappropriate sinus tachycardia is most often treated with beta-blockers; in resistant cases, nonpharmacologic treatment has been attempted. Recent case reports have shown a favorable response to ivabradine in some patients.
Methods:
A total of 13 patients (11 women, 2 men) aged from 27 to 66 years (mean 42 +/- 8) and having inappropriate sinus tachycardia were treated with ivabradine 15 mg per day.
Results:
In 12 patients whose previous therapy could be discontinued or who did not have previous medication the mean daily heart rate decreased from 94.0 +/- 10.0 to 74.6 +/- 5.2 bpm (mean +/- SD) after ivabradine treatment. In 10 patients in whom we could reliably measure the highest and lowest daily heart rates, the highest rate decreased from 150.3 +/- 13.4 to 120.6 +/- 9.8 and the lowest from 66.7 +/- 9.6 to 54.8 +/- 6.9. All of the differences were statistically significant (P < 0.001). The percentage of heart rate reduction correlated with the initial heart rate (P < 0.005). The remaining patient, who had been treated with metoprolol 300 mg per day for more than 10 years and still had a resting heart rate of 106 bpm, switched to 15 mg of ivabradine daily without discontinuation of drug therapy. After this switch, a decrease of 4 bpm was noted in her mean daily heart rate.
Conclusions:
The results of our study show that patients with inappropriate sinus tachycardia can be successfully treated with ivabradine.
More Related Videos
08:42Cox-Maze IV Procedure Concomitant with Valvular Surgery In Situs Inversus Dextrocardia: A Single-Center Experience in China
Published on: February 11, 2022
09:20Microelectrode Array Recording of Sinoatrial Node Firing Rate to Identify Intrinsic Cardiac Pacemaking Defects in Mice
Published on: July 5, 2021
Related Concept Videos
ECG Interpretation of Arrhythmias I: Sinus Arrhythmias
Types of Arrhythmias
Sinus Node Arrhythmias
Sinus Bradycardia: Originating from the sinoatrial (SA) node, sinus bradycardia involves slower impulses, resulting in a heart rate of less than 60 beats per minute (bpm). Causes include sleep, vagal stimulation, beta-blockers, hypothyroidism, and...
Dysrhythmias VI: Management of Dysrhythmias
Antiarrhythmic Drugs: Class IV Agents as Calcium Channel Blockers
Verapamil, a calcium channel blocker, inhibits calcium movement across myocardial cell membranes and vascular smooth muscle. This results in the dilation of coronary and...
Disturbances in Heart Rhythm
Arrhythmias are categorized by their speed, rhythm, and origin. A slow heart...
ECG Interpretation of Arrhythmias II: Atrial, Junctional and Ventricular Arrhythmias
Dysrhythmias IV: Characteristics of Bradyarrhythmias
