Key result
Ivabradine successfully lowered heart rate and eliminated evidence of POTS on repeat autonomic function testing in a patient with resistant inappropriate sinus tachycardia.
Why the study?
Does ivabradine reduce heart rate and improve symptoms in a patient with POTS and inappropriate sinus tachycardia?
Case Report (n=1)
Does ivabradine reduce heart rate and improve symptoms in a patient with POTS and inappropriate sinus tachycardia?
Ivabradine may be an effective treatment option for patients with inappropriate sinus tachycardia and POTS who are resistant to traditional rate-slowing medications.
May support ivabradine in refractory IST/POTS; hypothesis-generating and requires prospective confirmation.
We present the case of a 44-year-old woman with postural orthostatic tachycardia syndrome (POTS) and a dual chamber pacemaker. The patient suffered from inappropriate sinus tachycardia that had been resistant to treatment with traditional rate-slowing medications. Ivabradine--the specific sinus node I(f) current inhibitor--was used to successfully lower the heart rate. The patient had no evidence of POTS on repeat autonomic function testing, and there was a corresponding symptomatic benefit. We propose that this class of drugs, the use of which is established as antianginals, should be considered in patients with resistant inappropriate sinus tachycardia.
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Khan et al. (2008) conducted a case report in Postural orthostatic tachycardia syndrome (POTS) and inappropriate sinus tachycardia (n=1). Ivabradine was evaluated on Heart rate reduction and autonomic function testing. Ivabradine successfully lowered heart rate and eliminated evidence of POTS on repeat autonomic function testing in a patient with resistant inappropriate sinus tachycardia.
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