If channel inhibitors (Ivabradine) for HF

What is the rationale for using Ivabradine?

heart rate is a strong predictor of mortality in HF patients, ivabradine lowers heart rate

What is the MOA of ivabradine?

selectively inhibits If channel in SA node, reduce heart rate in patients in sinus rhythm, blocking action potentials as the opening of this current sets them off

What are the positive clinical effects?

• significant reductions in hospitalization

• slight reduction in CV mortality 

Who is indicated for use of ivabradine?

patients with HFrEF in sinus rhythm with resting HR of over 75, with persistent symptoms despite being on ACEI, BB, MRA or ARNI, or in whom BB therapy is contraindicated 

What are the possible adverse effects of ivabradine?

• bradycardia

• AV block, headache and dizziness

• visual disturbances, phosphenes and blurred vision