SHIFTing to a lower gear


High heart rates have long been recognised as cardiovascular risk, and ivabradine is a relatively new medication that works on If channels to reduce heart rate selectively, without the extra effects that beta blockers and calcium channel blockers bring. It follows therefore that it would be useful in heart failure – and it appears that it just might be. 


Before you go on, note that the study is funded by the company who make the drug. Important to keep in mind. In any case, the results are positive – the hazard ratio was 0.82 for patients taking ivabradine in relation to a composite of death/admission for heart failure, however there was more severe bradycardia and visual disturbance in the drug group. 

Ivabradine will likely become a drug used commonly for heart failure down the track – but more independent RCTs will have to come first. Get in early and find out more at the Lancet here and here. A little more on high resting heart rate over at JAMA as well here




IMAGE: Glenlarson
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