Selective If-channel inhibitor ivabradine in the treatment of sinus tachycardia in coronary heart disease patients with acute heart failure and inferior myocardial infarction

Abstract

Aim. To assess the effectiveness of ivabradine therapy in heart rate (HR) reduction among patients with acute heart failure (AHF). Material and methods. ОIn total, 40 dopamine-treated patients with inferior myocardial infarction (MI) were examined. All participants were randomised into Groups A (n=21; ivabradine dose 10-20 mg/d) and B (n=19; controls). In all patients, HR was measured, and echocardiography was performed. Results. In Group A, HR decreased as early as 12 hours after the start of ivabradine therapy, from 106,4±2,7 to 98,5±2,8 bpm (p<0,05), while in Group B, no HR reduction was observed in the first 24 hours. By Day 14, HR was reduced in both groups. In Group A, however, it was significantly lower — 81,5±1,8 vs. 91,6±2,5 bpm (p<0,001), despite similar baseline HR levels. According to the echocardiography results, Group A demonstrated an increase in left ventricular ejection fraction (LV EF), from 29,4±1,7 to 34,9±1,8 % (р<0,05), without LV dilatation. In Group B, no LV EF increase was observed by Day 14, and LV size increased from 56,8±1,1 to 60,5±1,2 mm (p<0,005). Conclusion. Ivabradine reduced HR in AHF, which was associated with improved LV contractility and prevented further LV dilatation.