| Author/Editor | Böhm, Michael; Borer, Jeffrey S.; Camm, A. John; Ford, Ian; Lloyd, Suzanne M.; Komajda, Michel; Tavazzi, Luigi; Talajic, Mario; Lainščak, Mitja; Reil, Jan-Christian; Ukena, Christian; Swedberg, Karl | |
| Title | Twenty-four-hour heart rate lowering with ivabradine in chronic heart failure: insights from the SHIFT Holter substudy | |
| Type | članek | |
| Vol. and No. | Letnik 17, št. 5 | |
| Publication year | 2015 | |
| Volume | str. 518-526 | |
| ISSN | 1388-9842 - European journal of heart failure | |
| Language | eng | |
| Abstract | Aims: Analysis of 24-h Holter recordings was a pre-specified substudy of SHIFT (Systolic Heart Failure Treatment with the If Inhibitor Ivabradine Trial) for exploring the heart rhythm safety of ivabradine and to determine effects of ivabradine on 24-h, daytime, and night-time heart rate (HR) compared with resting office HR. Methods and results: The 24-h Holter monitoring was performed at baseline and 8 months after randomization to ivabradine (n = 298) or matching placebo (n = 304) titrated maximally to 7.5 mg b.i.d. in patients with baseline HR >-70 b.p.m. Patients received guideline-based optimized heart failure therapy including ACE inhibitors and/or ARBs in 93% and beta-blockers at maximally tolerated doses in 93%. After 8 months, HR over 24 h decreased by 9.5+-10.0 b.p.m. with ivabradine, from 75.4+-10.3 b.p.m. (P < 0.0001), and by 1.2+-8.9 b.p.m. with placebo, from 74.8+-9.7 b.p.m. (P < 0.0001 for difference vs. ivabradine). HR reduction with ivabradine was similar in resting office and in 24-h, awake, and asleep recordings, with beneficial effects on HR variability and no meaningful increases in supraventricular or ventricular arrhythmias. At 8 months, 21.3% on ivabradine vs. 8.5% on placebo had >-1 episode of HR <40 b.p.m. (P < 0.0001). No episode of HR <30 b.p.m. was recorded; 3 (1.2%) patients had RR intervals >2.5 s on ivabradine vs. 4 (1.6%) patients on placebo. No RR intervals >3 s were identified in patients taking ivabradine. Conclusion: Ivabradine safely and significantly lowers HR and improves HR variability in patients with systolic heart failure, without inducing significant bradycardia, ventricular arrhythmias, or supraventricular arrhythmias. | |
| Descriptors | Heart failure Heart rate Electrocardiography, ambulatory Cardiovascular agents Srčno popuščanje Srčni utrip Elektrokardiografija, ambulamtna Zdravila za srce in ožilje | |
| Keywords | ivabradine |