[Management of cardiac failure: a guilty one easy to target!]

The proven benefits of beta blockers and angiotensin converting enzyme (ACE) inhibitors in the treatment of chronic heart failure, could be linked, at least in part, to their heart-rate-lowering properties. The link between a high heart rate and cardiovascular morbidity and mortality has been demonstrated in the general population, as well as in patients with hypertension, coronary artery disease, and chronic heart failure. Ivabradine is a specific inhibitor of the if current in the sino-atrial node, without any other known cardiovascular effect, such as myocardial contraction or intracardiac conduction. The effects of ivabradine on reducing resting heart-rate, and, therefore, cardiovascular outcomes have been studied in two large studies: BEAUTIFUL, and, more recently, SHIFT, both of which are discussed in this article.