August 28, 2017Open Access
View Full PaperIvabradine in the treatment of postural tachycardia syndrome (POTS), a single center experience
Key Result
Ivabradine treatment in patients with postural tachycardia syndrome improved symptoms in 78% of the cohort and significantly reduced standing heart rate (107.4 vs 95.1 bpm, P<0.001).
Study Design
Type
Cohort (n=49)
Multicenter
No
Structured PICO
Does ivabradine improve symptoms and reduce heart rate in patients with postural tachycardia syndrome (POTS)?
P
Population
49 patients diagnosed with postural tachycardia syndrome (POTS), mean age 35.1, 95.9% female.
I
Intervention
Ivabradine
O
Outcome
Improvement in symptoms (palpitations and lightheadedness) and objective decrease in sitting and standing heart ratepatient reported
Ivabradine appears effective and safe for improving symptoms and reducing standing heart rate in patients with postural tachycardia syndrome.
Main Result
Absolute Event Rate: 95.1% vs 107.4%
p-value: p=< 0.001
Abstract
BACKGROUND: channel blocker that reduces heart rate without affecting other cardiovascular functions. In case reports and case series, it was shown to improve symptoms in patients with postural tachycardia syndrome (POTS). METHODOLOGY AND RESULTS: This retrospective study examined patients who were diagnosed with POTS and received ivabradine as part of their treatment. Forty-nine patients (47 females, 95.9%) received ivabradine. The average age was 35.1 ± 10.35 years. The most common symptoms were palpitations and lightheadedness and both improved significantly, 88.4% and 76.1% response rate, respectively. A total of 38 patients reported improvement in their symptoms. In addition, ivabradine resulted in an objective decrease in sitting and standing heart rate (78.1 ± 10.7 vs 72.5 ± 7.6, P-value: 0.01) and (107.4 ± 14.1 vs 95.1 ± 13.7, P-value: < 0.001), respectively, with no significant change in blood pressure. The most common reported side effect was luminous phenomena/visual brightness occurring in nine patients. However, none of the patients stopped ivabradine due to side effects. CONCLUSION: Our study shows that ivabradine is likely to be effective in treating patients with POTS. Nearly 78% of our cohort reported a significant improvement in symptoms with no major adverse effects reported. A future randomized, placebo-controlled trial is warranted.