Ivabradine use throughout pregnancy for long-COVID POTS resulted in a healthy neonate delivered at 38 weeks 5 days, with normal fetal assessments and no evidence of bradycardia or abnormalities.
Case Report
No
Does ivabradine use throughout pregnancy cause adverse maternal or fetal outcomes in a patient with POTS?
1 35-year-old gravida 2 para 1 female with long-COVID postural orthostatic tachycardia syndrome (POTS), irritable bowel syndrome, and mood/anxiety disorders.
Ivabradine 12.5 mg twice daily continued from preconception through delivery (38 weeks 5 days), alongside propranolol 40 mg four times daily, midodrine 15 mg three times daily, methyldopa 125 mg nightly, and nifedipine 30 mg once daily.
Maternal and fetal outcomes (fetal growth, fetal Dopplers, non-stress tests, neonatal health)safety
This case provides the first evidence of uninterrupted ivabradine exposure across all three trimesters of pregnancy with reassuring maternal and fetal outcomes in a patient with POTS.
We report on a 35-year-old gravida 2 para 1 female with long-COVID postural orthostatic tachycardia syndrome (POTS) who continued all pharmacologic therapies from preconception through delivery, including ivabradine, a medication contraindicated in pregnancy due to preclinical embryotoxicity and teratogenicity.Serial fetal assessments including growth studies, fetal Dopplers, and non-stress tests remained normal throughout gestation without evidence of fetal bradycardia, arrhythmia, or structural abnormalities.Delivery at 38 weeks 5 days' gestation resulted in a healthy female neonate.This case illustrates successful use of off-label ivabradine in pregnancy with reassuring maternalfetal outcomes under close obstetric-cardiology supervision.
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Raneet K. Kahlon
J. Laurin
Ermin Nath
Canadian Journal of Cardiology
University of Alberta
University of Calgary
Libin Cardiovascular Institute of Alberta
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Kahlon et al. (Wed,) conducted a case report in Postural Orthostatic Tachycardia Syndrome (POTS) (n=1). Ivabradine was evaluated on Maternal-fetal outcomes. Ivabradine use throughout pregnancy for long-COVID POTS resulted in a healthy neonate delivered at 38 weeks 5 days, with normal fetal assessments and no evidence of bradycardia or abnormalities.
www.synapsesocial.com/papers/69f2f1471e5f7920c638700d — DOI: https://doi.org/10.1016/j.cjca.2026.04.019