Key result
Ivabradine (5-10 mg/day) prevented inappropriate ICD shocks due to sinus tachycardia, with 0 events recorded over 14 months in a series of 5 high-risk patients.
Why the study?
Does ivabradine prevent inappropriate shocks due to sinus tachycardia in patients with an implanted cardioverter defibrillator?
Observational (n=5)
Open-label
Does ivabradine prevent inappropriate shocks due to sinus tachycardia in patients with an implanted cardioverter defibrillator?
In a small case series, the addition of ivabradine to beta-blocker therapy successfully prevented inappropriate ICD shocks due to sinus tachycardia over 14 months.
May support ivabradine to avert inappropriate ICD shocks in select patients; hypothesis-generating case series leaves open need for RCTs.
AIMS: Ivabradine is a specific blocker of the pacemaker current (I(f)) used to decrease the sinus rate. Several clinical trials have shown that it is beneficial, with or without concomitant beta-blocker therapy, in patients with stable angina or heart failure. We sought to take advantage of ivabradine's ability to decrease the maximal obtainable sinus rate in order to prevent inappropriate shocks due to sinus tachycardia in patients with an implanted cardioverter defibrillator (ICD). METHODS AND RESULTS: Prospective open-label series including all our patients with an implanted ICD who, during the course of 2010-2011, received ivabradine with the only purpose of preventing inappropriate ICD shocks for sinus tachycardia. These are patients who received one or more inappropriate shocks for sinus tachycardia or were conceived to be at very high risk for developing such complication. Our series includes five patients who received ivabradine (5-10 mg/day) in addition to their usual beta-blocker therapy. During a follow-up of 14 months no inappropriate shocks due to sinus tachycardia were recorded. CONCLUSION: It is sensible to recommend ivabradine for the prevention of inappropriate ICD shocks due to sinus tachycardia in carefully selected patients.
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Adler et al. (2012) conducted an observational in Implanted cardioverter defibrillator (ICD) with inappropriate shocks for sinus tachycardia (n=5). Ivabradine was evaluated on Inappropriate shocks due to sinus tachycardia. Ivabradine (5-10 mg/day) prevented inappropriate ICD shocks due to sinus tachycardia, with 0 events recorded over 14 months in a series of 5 high-risk patients.
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