Effects of Ivabradine on Patients with Depressed Left Ventricular Function after Cardiac Resynchronization Therapy.

Autor:	Chang HY; Heart Center, Cheng Hsin General Hospital.; Faculty of Medicine, Institute of Clinical Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei., Huang HT; Department of Internal Medicine., Wang CY; Cardiovascular Center, Taichung Veterans General Hospital, Taichung., Lo HC; Cardiovascular Center, Taichung Veterans General Hospital, Taichung., Chen HJ; Cardiovascular Center, Taichung Veterans General Hospital, Taichung., Feng AN; Heart Center, Cheng Hsin General Hospital.; Faculty of Medicine, Institute of Clinical Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei., Fong MC; Heart Center, Cheng Hsin General Hospital.; Faculty of Medicine, Institute of Clinical Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei., Chen CN; Department of Pharmacy, Cheng Hsin General Hospital, Taipei., Chang HC; Department of Pharmacy, Cheng Hsin General Hospital, Taipei., Chiang KF; Cardiology Division, Asian University Hospital., Huang JL; Faculty of Medicine, Institute of Clinical Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei.; Cardiovascular Center, Taichung Veterans General Hospital, Taichung.; Department of Medical Education.; Department of Nuclear Medicine, Taichung Veterans General Hospital, Taichung, Taiwan.
Jazyk:	angličtina
Zdroj:	Acta Cardiologica Sinica [Acta Cardiol Sin] 2022 Jul; Vol. 38 (4), pp. 475-484.
DOI:	10.6515/ACS.202207_38(4).20211228B
Abstrakt:	Background: The potential synergistic effect of ivabradine and cardiac resynchronization therapy (CRT) in heart failure (HF) patients has rarely been studied. We aimed to evaluate the clinical benefits of ivabradine in patients with left ventricular dysfunction following CRT implantation. Methods: Two hundred and thirty-one patients receiving CRT were consecutively enrolled between January 2014 and December 2018 from two HF centers. A total of 123 patients had left ventricular ejection fraction (LVEF) < 40% and resting sinus heart rate (HR) ≥ 75 bpm after six months of CRT implantation. Among these patients, 45 were treated with ivabradine (Group 1), and 78 did not receive ivabradine treatment (Group 2). Results: Baseline characteristics and prescription rates of HF medications other than ivabradine were similar between the two groups. In Group 1, the mean HR decreased from 82.2 ± 11.4 bpm to 76.3 ± 10.5 bpm (p = 0.012), and the mean LVEF increased from 29.9 ± 6.5% to 38.8 ± 12.4% (p < 0.001). Atrial pacing percentage, biventricular pacing percentage, and burden of atrial fibrillation (AF) were not significantly different between the two groups during the study period. The patients' daily physical activity increased significantly in Group 1 compared to Group 2 (Δ daily activity 0.4 ± 0.7 hours/day vs. -0.1 ± 7.2 hours/day, p < 0.001). Conclusions: Ivabradine could effectively reduce HR and improve physical activity. It was safe to use and did not increase AF burden or affect biventricular pacing percentage in CRT recipients.
Databáze:	MEDLINE
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