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Published on: April 11, 2025
Heart-Rate Reduction With Adjusted-Dose Ivabradine in Patients Undergoing Coronary Computed Tomographic Angiography:
Blaž Kacijan1, Zala Novak, Borut Jug
1From the *University of Ljubljana, Faculty of Medicine; and Departments of †Vascular Diseases and ‡Nuclear Medicine, Ljubljana University Medical Centre, Ljubljana, Slovenia.
Objective:
Our prospective, randomized, open-label study assessed the efficacy of a heart rate-lowering, adjusted-dose protocol with ivabradine prior to coronary computed tomographic angiography (CCTA).
Methods:
Patients undergoing CCTA were randomized to 7 days of adjusted-dose ivabradine or standard care (ie, no additional medication). Heart rate and β-blocker and antianxiety medication use on the day of the CCTA were recorded.
Results:
One hundred one patients were randomized (mean age, 60 [SD, 13] years; 66% women). Significantly more patients on ivabradine had heart rates of 60 beats per minute or less at the time of the CCTA scan (48% vs 8%, P < 0.01); accordingly, fewer patients on ivabradine needed additional heart rate lowering with β-blockers (40% vs 86%, P < 0.01), as well as antianxiety medication (18% vs 39%, P < 0.05), and also required lower doses of intravenous β-blockers (4 [SD, 2] vs 7 [SD, 5] mg, P < 0.05).
Conclusions:
A 7-day premedication protocol with ivabradine effectively lowers heart rate in patients undergoing CCTA.
