Ivabradine: pre-clinical and clinical evidence in the setting of ventricular arrhythmias

G Bazoukis; B Hill; G Tse; K K Naka

Ivabradine: pre-clinical and clinical evidence in the setting of ventricular arrhythmias

Hippokratia. 2022 Apr-Jun;26(2):49-54.

Authors

G Bazoukis^{1

2}, B Hill³, G Tse^{4

5}, K K Naka⁶

Affiliations

¹ Department of Cardiology, Larnaca General Hospital, Larnaca, Cyprus.
² Department of Basic and Clinical Sciences, University of Nicosia Medical School, Nicosia, Cyprus.
³ Department of Medicine, Queen's University, Kingston, Ontario, Canada.
⁴ Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin, China.
⁵ Kent and Medway Medical School, Canterbury, Kent, United Kingdom.
⁶ Second Department of Cardiology and Michaelidion Cardiac Center, Medical School University of Ioannina, Ioannina, Greece.

PMID: 37188047
PMCID: PMC10177854

Abstract

Background: Ivabradine, an agent lowering the heart rate, acting as a funny current (I_f) specific inhibitor, is responsible for the sinoatrial node's spontaneous depolarization. According to current guidelines, it is indicated in specific heart failure populations and as a second-line treatment option to improve angina in chronic coronary syndromes.

Review of literature: The role of ivabradine in the setting of ventricular arrhythmias has been studied in both experimental and clinical studies. Specifically, experimental studies have examined the role of ivabradine in acute myocardial ischemia, reperfusion, digitalis-induced ventricular arrhythmias, and catecholaminergic polymorphic ventricular tachycardia showing promising results. In addition, clinical studies have shown a beneficial role of ivabradine in reducing ventricular arrhythmias. Ivabradine reduced premature ventricular contractions in combination with beta-blockers in dilated cardiomyopathy patients. Similarly, in catecholaminergic polymorphic ventricular tachycardia, ivabradine reduced dobutamine-induced premature ventricular complexes and improved ventricular arrhythmias burden. On the other hand, current data show no beneficial role of ivabradine in reducing ventricular arrhythmias in myocardial ischemia.

Conclusions: Randomized clinical trials are needed to elucidate the role of ivabradine in reducing the burden of ventricular arrhythmias in various clinical settings. HIPPOKRATIA 2022, 26 (2):49-54.

Keywords: Ivabradine; ventricular arrhythmias; ventricular tachycardia.

Publication types

Review