January 1, 2014Arquivos Brasileiros de CardiologiaOpen Access

Ivabradine Improves Heart Rate Variability in Patients with Nonischemic Dilated Cardiomyopathy

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Why the study?

Does ivabradine improve heart rate variability in patients with nonischemic dilated cardiomyopathy?

Structured PICO

Does ivabradine improve heart rate variability in patients with nonischemic dilated cardiomyopathy?

Population

48 patients with compensated heart failure of nonischemic origin (idiopathic dilated cardiomyopathy), LVEF ≤35%, sinus rhythm with resting HR ≥70 bpm, and NYHA class II-III on optimized background therapy. Mean age 70.9 years, 43% women.

Intervention

Ivabradine (starting dose 5 mg twice daily, titrated up to 7.5 mg twice daily or down to 2.5 mg twice daily based on heart rate) added to background cardiovascular therapy for 8 weeks.

Outcome

Time domain indices of heart rate variability (HRV) including mean RR interval, SDNN, SDANN, SDNN index, pNN50, and RMSSD measured by 24-h Holter recording at 8 weeks.surrogate

In patients with nonischemic dilated cardiomyopathy, 8 weeks of ivabradine therapy significantly improved time-domain indices of heart rate variability, suggesting enhanced cardiac autonomic regulation.

Limitations

Not a placebo-controlled, randomized study
Small sample size
No follow-up beyond 8 weeks
Only approximately half the patients were titrated to the recommended 7.5 mg twice daily dose
Natriuretic peptide levels not measured
Heart rate turbulence and frequency domain indices of HRV not assessed
NYHA class IV and COPD patients excluded

Discussion

No takes yet. Share an insight, caveat, or question.

Implication

May support autonomic benefits of ivabradine in nonischemic dilated cardiomyopathy; hypothesis-generating and should not yet change practice.

Cite This Study

Kurtoğlu et al. (2014) studied this question.

synapsesocial.com/papers/6a7f65f511d2ce75ff8b1dda https://doi.org/10.5935/abc.20140109

Topics

Heart failure HFrEF treatment

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Implication

May support autonomic benefits of ivabradine in nonischemic dilated cardiomyopathy; hypothesis-generating and should not yet change practice.

Ivabradine Improves Heart Rate Variability in Patients with Nonischemic Dilated Cardiomyopathy

Structured PICO

Limitations

Discussion

Implication

Cite This Study

Topics

Ivabradine Improves Heart Rate Variability in Patients with Nonischemic Dilated Cardiomyopathy

Structured PICO

Limitations

Discussion

Implication

Cite This Study

Also Consider

Topics

Also Consider