Ivabradine-Induced Torsade de Pointes in Patients with Heart Failure Reduced Ejection Fraction
Ji-Hun Jang1,2, Sung Woo Kwon2, Man-Jong Lee2,3
1Department of Hospital Medicine, Inha University College of Medicine.
International Heart Journal
|September 14, 2020
Summary
Ivabradine can treat heart failure but may cause Torsade de pointes (TdP) in some patients. Caution is advised when using ivabradine with conditions causing QT prolongation or metabolic issues.
Area of Science:
- Cardiology
- Pharmacology
Background:
- Ivabradine selectively inhibits the sinoatrial node funny current, prolonging diastolic depolarization.
- It is recommended for heart failure with reduced ejection fraction (HFrEF) alongside beta-blockers to further reduce heart rate.
Observation:
- Previous reports suggest a link between ivabradine and Torsade de pointes (TdP).
- This association is noted with concurrent use of drugs causing QT prolongation or inhibiting ivabradine's metabolism.
Findings:
- This article presents two cases of HFrEF patients who developed TdP after initiating ivabradine.
- These cases underscore potential risks associated with ivabradine administration.
Implications:
- Clinicians should exercise caution when prescribing ivabradine, especially in patients with a reduced repolarization reserve.
- Conditions like QT prolongation or metabolic insufficiency warrant careful consideration to mitigate TdP risk.
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