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  • Title: Treatment of inappropriate sinus tachycardia with ivabradine.
    Author: Rakovec P.
    Journal: Wien Klin Wochenschr; 2009; 121(21-22):715-8. PubMed ID: 19998013.
    Abstract:
    BACKGROUND: Inappropriate sinus tachycardia is most often treated with beta-blockers; in resistant cases, nonpharmacologic treatment has been attempted. Recent case reports have shown a favorable response to ivabradine in some patients. METHODS: A total of 13 patients (11 women, 2 men) aged from 27 to 66 years (mean 42 +/- 8) and having inappropriate sinus tachycardia were treated with ivabradine 15 mg per day. RESULTS: In 12 patients whose previous therapy could be discontinued or who did not have previous medication the mean daily heart rate decreased from 94.0 +/- 10.0 to 74.6 +/- 5.2 bpm (mean +/- SD) after ivabradine treatment. In 10 patients in whom we could reliably measure the highest and lowest daily heart rates, the highest rate decreased from 150.3 +/- 13.4 to 120.6 +/- 9.8 and the lowest from 66.7 +/- 9.6 to 54.8 +/- 6.9. All of the differences were statistically significant (P < 0.001). The percentage of heart rate reduction correlated with the initial heart rate (P < 0.005). The remaining patient, who had been treated with metoprolol 300 mg per day for more than 10 years and still had a resting heart rate of 106 bpm, switched to 15 mg of ivabradine daily without discontinuation of drug therapy. After this switch, a decrease of 4 bpm was noted in her mean daily heart rate. CONCLUSIONS: The results of our study show that patients with inappropriate sinus tachycardia can be successfully treated with ivabradine.
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