Potential New Indication for Ivabradine: Treatment of a Patient with Congenital Junctional Ectopic Tachycardia

Al-Ghamdi, Saleh; Al-Fayyadh, Majid; Hamilton, Robert M.

doi:10.1111/jce.12081

Cited by 39 publications

(34 citation statements)

References 10 publications

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“…Among the most encouraging case reports on this subject is the case of Al‐Ghamdi and his colleagues . In a 3‐year‐old girl with tachycardia that was resistant to sotalol and flecainide treatment, sinus rhythm was restored through ivabradine at 2.5 mg/day.…”

Section: Discussionmentioning

confidence: 99%

“…Ivabradine, known as a cardiac pacemaker cell inhibitor, is a new‐generation antiarrhythmic used to treat inappropriate sinus tachycardia and angina pectoris in adult patients . Two case studies have previously indicated that ivabradine can be used off‐label as pediatric congenital JET treatment . In this article, we present three cases in which individuals with congenital JET were successfully treated with ivabradine.…”

Section: Introductionmentioning

confidence: 99%

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Ivabradine is an effective antiarrhythmic therapy for congenital junctional ectopic tachycardia‐induced cardiomyopathy during infancy: Case studies

Ergül¹,

Öztürk²,

Özgür³

et al. 2018

Pacing Clinical Electrophis

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Junctional ectopic tachycardia (JET) is a rare form of arrhythmia that is most commonly seen during infancy. JET is continuous and incessant, characterized by persistently high heart rates that may result in impaired cardiac function and tachycardia-induced cardiomyopathy. Despite the availability of multiple antiarrhythmic treatments, including flecainide and amiodarone, management of JET is generally very difficult. Catheter ablation has a high risk of atrioventricular block and it may require the placement of a pacemaker. Ivabradine, also known as a cardiac pacemaker cell inhibitor, is a new-generation antiarrhythmic used to treat sinus tachycardia and angina pectoris in adult patients. In this article, we present three cases of subjects with infantile congenital JET who were admitted to our clinic with a tachycardia-induced cardiomyopathy. The age of the subjects ranged from 52 days to 10 months. Although the cases of tachycardia could not be controlled by multiple antiarrhythmics, including a combination of amiodarone and flecainide combined with either propranolol or digoxin, they were rapidly converted into sinus rhythm with an ivabradine treatment of 0.1-0.2 mg/kg/day. No cardiac or other side effects were observed during ivabradine treatment, and left ventricular functions and rhythms improved within 24 hours. These three cases therefore provide hope that ivabradine may be a suitable standard initial treatment for congenital JET. However, additional research is needed to confirm the validity of these results in other circumstances.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Ivabradine is an effective antiarrhythmic therapy for congenital junctional ectopic tachycardia‐induced cardiomyopathy during infancy: Case studies

Ergül¹,

Öztürk²,

Özgür³

et al. 2018

Pacing Clinical Electrophis

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show abstract

“…The second also based on an increased automaticity mechanism, an incessant junctional ectopic tachycardia in a 2-year-old girl where ivabradine both acutely and chronically allowed to postpone an ablation procedure. 16 We do not know if our case can be a model for the treatment of all focal atrial tachycardia, but due to the presence of I(f) channels in PV and in atrium, we can suppose that the reduction of heart frequency could occur in other forms of arrhythmia generated by an ectopic atrial focus. Finally, our case, together with the other presented cases, suggests the use of ivabradine for at least 3 reasons: first because ivabradine gives symptomatic relief by reducing the automatic focus discharge; second, it allows to probe the possible automatic based versus reentrant pathogenic mechanism; and last, it can be useful as a bridge to a subsequent electrophysiological study.…”

Section: Discussionmentioning

confidence: 98%

“…Similar to our case, the tachycardia was successfully treated with ivabradine to control heart rate allowing a later and successful second ablation to be performed. The second also based on an increased automaticity mechanism, an incessant junctional ectopic tachycardia in a 2‐year‐old girl where ivabradine both acutely and chronically allowed to postpone an ablation procedure …”

Section: Discussionmentioning

confidence: 99%

A Case of Atrial Tachycardia Treated with Ivabradine as Bridge to Ablation

Meles¹,

Carbone²,

Maggiolini³

et al. 2015

Cardiovasc electrophysiol

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Ivabradine is indicated in cardiac failure and ischemia to reduce sinus rate by inhibition of the pacemaker I(f) current in sinoatrial node. We report a case of an 18-year-old woman with left atrial tachyarrhythmia resistant to several antiarrhythmic drugs and to electric cardioversion who responded only to ivabradine, which significantly reduced heart rate without abolishing the arrhythmia itself. An ectopic focus in the ostium of left pulmonary veins was found and the patient was successfully ablated. We suggest that ivabradine might be therefore useful in the treatment of supraventricular tachyarrhythmias due to an enhanced automaticity.

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“…Hamując wybiórczo węzeł zatokowy, jednocześnie nie wpływa na przewodzenie i refrakcję przedsionków oraz komór [2]. Pojedyncze kazuistyczne doniesienia naukowe zawierają informacje o skuteczności iwabradyny w terapii ektopowych częstoskurczów przedsionkowych lub ustawicznych ogniskowych węzłowych częstoskurczów u niemowląt i małych dzieci [3]. Iwabradyna szybko spowodowała wyraźne zwolnienie częstoskurczu u opisanej pacjentki i całkowite ustąpienie dolegliwości subiektywnych.…”

Section: Omówienieunclassified