What question did this study set out to answer?

To evaluate the long-term effectiveness of ivabradine on heart rate control and quality of life in inappropriate sinus tachycardia, and assess outcomes after drug discontinuation.

March 19, 2013Pacing and Clinical Electrophysiology

Long‐Term Outcomes of Ivabradine in Inappropriate Sinus Tachycardia Patients: Appropriate Efficacy or Inappropriate Patients

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Why the study?

Does ivabradine improve heart rate control and quality of life in patients with inappropriate sinus tachycardia?

Key Points

To evaluate the long-term effectiveness of ivabradine on heart rate control and quality of life in inappropriate sinus tachycardia, and assess outcomes after drug discontinuation.
Enrolled 24 patients (18 women, mean age 41 ± 13 years) diagnosed with inappropriate sinus tachycardia by guideline criteria.
Administered ivabradine 5–7.5 mg twice daily (mean dose 5.8 ± 1.4 mg) with 24-hour Holter monitoring and SF-36 Health Survey evaluation at 6 months.
Offered treatment cessation at 1 year to evaluate the persistence of tachycardia off-therapy.
Ivabradine reduced average maximal heart rate (155 ± 18 vs 132 ± 16 beats/min), mean heart rate (97 ± 6 vs 79 ± 8 beats/min; daytime 103 ± 8 vs 84 ± 10 beats/min), and minimal heart rate (58 ± 12 vs 48 ± 7 beats/min; all P < 0.05).
SF-36 total scores improved from 57 ± 23 to 76 ± 20, including physical (56 ± 25 vs 74 ± 22) and mental (58 ± 24 vs 78 ± 18) subscores (P < 0.001), with no severe bradycardia or syncope reported.
Among 10 patients who agreed to stop treatment after 1 year, only 2 patients (20%) met criteria for inappropriate sinus tachycardia, indicating normal heart rates persisted in 80%.

Structured PICO

Does ivabradine improve heart rate control and quality of life in patients with inappropriate sinus tachycardia?

Population

24 patients (18 women, mean age 41 ± 13 years) diagnosed with inappropriate sinus tachycardia (IST) according to current guidelines criteria.

Intervention

Ivabradine 5-7.5 mg twice a day (mean dose 5.8 ± 1.4 mg).

Outcome

Heart rate control (average maximal, mean, mean daytime, and minimal HR) on 24-hour Holter recordings and clinical status (SF-36 Health Survey) at 6 months.surrogate

Ivabradine effectively normalizes heart rate and improves quality of life in patients with inappropriate sinus tachycardia, with sustained benefits even after discontinuation in a majority of patients.

Discussion

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Implication

May support ivabradine for HR control and QoL in IST; hypothesis-generating and requires randomized confirmation before practice change.

Cite This Study

Benezet‐Mazuecos et al. (2013) studied this question.

synapsesocial.com/papers/6a714e83a528af2d65c40399 https://doi.org/10.1111/pace.12118

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Long‐Term Outcomes of Ivabradine in Inappropriate Sinus Tachycardia Patients: Appropriate Efficacy or Inappropriate Patients

Key Points

Structured PICO

Discussion

Implication

Cite This Study

Long‐Term Outcomes of Ivabradine in Inappropriate Sinus Tachycardia Patients: Appropriate Efficacy or Inappropriate Patients

Key Points

Structured PICO

Discussion

Implication

Cite This Study

Also Consider

Also Consider