Ivabradine as an Alternative Therapeutic Trial in the Therapy of Inappropriate Sinus Tachycardia

Abstract

Inappropriate sinus tachycardia is a disease which is relatively rarely found and sometimes difficult to treat. Up to now it has been mostly treated with a β-blocker or verapamil. If this did not work sinus node modulation was considered. Since the relatively new selective IF-stream blocker ivabradine has been approved for the therapy of chronic stable angina pectoris, a new therapeutic option is available. As ivabradine is well tolerated and only few side effects are known, it may become a new therapeutic step between medication and the invasive sinus node modulation. We report the case of a young female patient with inappropriate sinus tachycardia where a sustained therapeutic success was achieved with ivabradine medication as an alternative therapeutic trial after various ineffective medications.

Treatment of inappropriate sinus tachycardia with ivabradine

“…Its mode of action is by blocking the "funny" current (If) responsible for spontaneous diastolic depolarization of pacemaker cells in the sinus node [17]. The therapeutic role of this drug in the treatment of sinus tachycardia therefore appears logical [18,19], as confirmed in published case reports [9][10][11][12]. The experience with the group of patients in the present study shows that ivabradine can normalize the heart rate in patients with inappropriate sinus tachycardia.…”

“…Apart from beta-blockers, other potentially effective drugs are nondihydropyridine calcium antag- Springer-Verlag 21-22/2009 wkw Treatment of inappropriate sinus tachycardia with ivabradine onists and amiodarone. Ivabradine, a drug that selectively decreases heart rate, has recently become available; case reports have already shown a favorable response in reported patients [9][10][11][12].…”

Is There a Role for Ivabradine Beyond its Conventional Use?

“…Initially, ivabradine was reported for its off-label efficacy in cases of inappropriate sinus tachycardia (IST) and postural orthostatic tachycardia syndrome (POTS) [19][20][21]. Cal o et al [22] in a case series that included 18 IST patients demonstrated the effects of ivabradine in reducing HR at the Holter recordings and to increasing the exercise tolerance in stress tests.…”

Ivabradine: a new rate-limiting therapy for coronary artery disease and heart failure

“…However, there is published evidence, albeit from only one case report, of the effectiveness of ivabradine in the treatment of inappropriate sinus tachycardia [Schulze et al 2008].…”