Effect of ivabradine on ventricular arrhythmias in heart failure patients with reduced ejection fraction
Levent Pay1, Ahmet Çağdaş Yumurtaş2, Ozan Tezen2
1Ardahan State Hospital, Department of Cardiology - Ardahan, Turkey.
Insights
Ivabradine use in heart failure patients with reduced ejection fraction was associated with fewer ventricular arrhythmias and appropriate implantable cardioverter-defibrillator shocks. This study suggests ivabradine may help manage life-threatening arrhythmias in these patients.
Area of Science:
- Cardiology
- Pharmacology
Background:
- Heart failure with reduced ejection fraction (HFrEF) patients face high risks of ventricular arrhythmias and sudden cardiac death.
- Ivabradine, a sinoatrial node If current inhibitor, reduces heart rate and manages angina in chronic coronary syndromes.
Purpose of the Study:
- To investigate the impact of ivabradine on life-threatening ventricular arrhythmias.
- To assess the effect of ivabradine on long-term mortality in HFrEF patients.
Main Methods:
- A retrospective study included 1,639 HFrEF patients, divided into ivabradine users and nonusers.
- Evaluated outcomes included ventricular tachycardia, premature ventricular contractions, implantable cardioverter-defibrillator shocks, and mortality.
Main Results:
- Ivabradine nonusers had a significantly higher incidence of ventricular tachycardia and premature ventricular contractions.
- Ivabradine nonusers experienced 4.1 times more appropriate implantable cardioverter-defibrillator shocks compared to users.
- No significant difference in long-term mortality was observed between the groups after adjustments.
Conclusions:
- Ivabradine use was linked to a reduction in appropriate implantable cardioverter-defibrillator discharges in HFrEF patients.
- Ivabradine shows potential as a treatment for ventricular arrhythmias in HFrEF patients.
Background/Introduction:
Heart failure patients with reduced ejection fraction are at high risk for ventricular arrhythmias and sudden cardiac death. Ivabradine, a specific inhibitor of the If current in the sinoatrial node, provides heart rate reduction in sinus rhythm and angina control in chronic coronary syndromes.
Objective:
The effect of ivabradine on ventricular arrhythmias in heart failure patients with reduced ejection fraction patients has not been fully elucidated. The aim of this study was to investigate the effect of ivabradine use on life-threatening arrhythmias and long-term mortality in heart failure patients with reduced ejection fraction patients.
Methods:
In this retrospective study, 1,639 patients with heart failure patients with reduced ejection fraction were included. Patients were divided into two groups: ivabradine users and nonusers. Patients presenting with ventricular tachycardia, the presence of ventricular extrasystole, and ventricular tachycardia in 24-h rhythm monitoring, appropriate implantable cardioverter-defibrillator shocks, and long-term mortality outcomes were evaluated according to ivabradine use.
Results:
After adjustment for all possible variables, admission with ventricular tachycardia was three times higher in ivabradine nonusers (95% confidence interval 1.5-10.2). The presence of premature ventricular contractions and ventricular tachycardias in 24-h rhythm Holter monitoring was notably higher in ivabradine nonusers. According to the adjusted model for all variables, 4.1 times more appropriate implantable cardioverter-defibrillator shocks were observed in the ivabradine nonusers than the users (95%CI 1.8-9.6). Long-term mortality did not differ between these groups after adjustment for all covariates.
Conclusion:
The use of ivabradine reduced the appropriate implantable cardioverter-defibrillator discharge in heart failure patients with reduced ejection fraction patients. Ivabradine has potential in the treatment of ventricular arrhythmias in heart failure patients with reduced ejection fraction patients.
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