Ivabradina como alternativa a la ablación del nódulo AV para un paciente con fibrilación auricular permanente

Ivabradine and AF: Coincidence, Correlation or a New Treatment?

“…In 2017, Fontenla et al published a case study in which a patient with a prosthetic mitral valve, permanent AF, left bundle branch block and severe LV systolic dysfunction had previously received a cardiac resynchronisation therapy defibrillation (CRT-D) device follow-up showed a 74% of biventricular pacing due to rapid conduction of AF over the AV node.The patient was already on a maximum tolerated dose of beta-blockers and had a history of digitalis toxicity. The administration of 5 mg of ivabradine twice daily raised the percentage of biventricular pacing to 95%, providing a good alternative to AV-nodal ablation 27. Based upon these findings, a randomised controlled multicentre clinical trial: the IvaBRAdine blocK of Funny Current for Heart Rate Control in permanEnt Atrial Fibrillation (BRAKE-AF Study; NCT03718273), is currently being conducted to evaluate the rate-lowering effect of ivabradine on patients with permanent AF.…”