Key result
Ivabradine initiation in a female patient induced Torsades de Pointes and isolated QTc interval prolongation, which resolved upon discontinuation of the drug.
Why the study?
Ivabradine causing isolated QTc interval prolongation without any provoking condition is rare.
Case Report (n=1)
Ivabradine may cause isolated QTc interval prolongation and Torsades de Pointes even in the absence of other provoking conditions.
Alerts clinicians to rare ivabradine-associated TdP risk; hypothesis-generating for QTc effects in HFrEF without confounders.
Ivabradine is used to control heart rate in patients of heart failure with reduced ejection fraction. Although considered safe, it is reported to prolong QTc interval when given with other QTc prolonging drugs or in setting of hypokalemia or hypomagnesemia. Ivabradine causing isolated QTc interval prolongation without any provoking condition is rare. Our patient developed Torsades de Pointes after initiating Ivabradine and her QTc interval reduced after stopping Ivabradine. This may be due to a potential independent dose dependent effect of Ivabradine on QTc interval by its effects on its effects on human Ether-à-go-go-Related Gene (hERG) potassium channels.
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Bhagwati et al. (2023) conducted a case report in Heart failure with reduced ejection fraction (n=1). Ivabradine was evaluated on Torsades de Pointes and QTc interval prolongation. Ivabradine initiation in a female patient induced Torsades de Pointes and isolated QTc interval prolongation, which resolved upon discontinuation of the drug.
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