Ivabradine is a new agent that selectively inhibits the I, channels of the sinus node. Electro-physiological studies have shown a significant heart rate lowering effect of ivabradine compared to placebo, while no significant changes have been observed in the frequency-corrected QT interval (QTc) or in the conductivity or refractoriness of the atrial muscle, AV node, His-Purkinje system or ventricular muscle. In a noninferiority study that compared ivabradine to atenolol, the same efficacy was shown in terms of increasing effort tolerance and reducing anginal events, with less reduction in heart rate. The same results were obtained with the comparison to amlodipine - the two drugs were equally efficient. The longest trial investigated the efficacy and safety of ivabradine for 12 month; both heart rate and the number of anginal episodes significantly decreased during the entire study period. The ongoing BEAUTIFUL trial tests ivabradine in patients with heart failure. The only important side effect of ivabradine is phosphenes, but this rarely requires the treatment to be discontinued. No other side effects such as symptomatic bradycardia or conduction abnormalities have been observed. Ivabradine is currently indicated as an alternative treatment of stable angina pectoris.
|Number of pages||5|
|Journal||Lege Artis Medicinae|
|Issue number||SUPPL. 2|
|Publication status||Published - Jun 11 2007|
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