Key result
Ivabradine administration in cardiogenic shock patients on VA-ECMO significantly reduced heart rate by 20.83 bpm (95% CI -27.2 to -14.4; P<0.01) and improved native stroke volume.
Why the study?
Ivabradine was safe in small non-randomized series of patients with cardiogenic shock without mechanical circulatory support, but its use in patients on mechanical circulatory support required evaluation.
Does ivabradine improve haemodynamics and reduce heart rate in patients with cardiogenic shock on VA-ECMO?
Cohort
Does ivabradine improve haemodynamics and reduce heart rate in patients with cardiogenic shock on VA-ECMO?
Mean Difference: -20.83 (95% CI -27.2–-14.4)
p-value: p=<0.01
In patients with cardiogenic shock on VA-ECMO, ivabradine significantly reduced heart rate and improved native stroke volume, facilitating the weaning of ECMO support and vasopressors.
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Suggests ivabradine may improve hemodynamics during VA-ECMO; leaves open whether this.
Colombo et al. (2022) conducted a cohort in Cardiogenic shock on mechanical circulatory support. Ivabradine vs. Matched cohort not receiving ivabradine was evaluated on Heart rate reduction (MD -20.83, 95% CI -27.2 to -14.4, p=<0.01). Ivabradine administration in cardiogenic shock patients on VA-ECMO significantly reduced heart rate by 20.83 bpm (95% CI -27.2 to -14.4; P<0.01) and improved native stroke volume.
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