Ivabradine for chronic heart rate control in persistent atrial fibrillation. Design of the BRAKE-AF project
| Autor: | Ángel Miracle-Blanco, Fernando Arribas, Adolfo Fontenla, Ricardo Salgado-Aranda, Jorge Toquero-Ramos, Isabel Montilla, Juan Tamargo-Menéndez, Miguel A. Arias, Juan Ramón Rey-Blas, Agustín Pastor-Fuentes, Roberto Matía-Francés, Brake-Af investigators, Elena Mejía-Martínez, María López-Gil, Agustín Gómez de la Cámara |
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| Rok vydání: | 2020 |
| Předmět: |
Digoxin
medicine.medical_specialty Equivalence Trials as Topic 030204 cardiovascular system & hematology Angina 03 medical and health sciences 0302 clinical medicine Heart Rate Internal medicine Atrial Fibrillation Heart rate medicine Humans Ivabradine business.industry Cardiovascular Agents Atrial fibrillation General Medicine medicine.disease Atrioventricular node Clinical trial Treatment Outcome medicine.anatomical_structure Heart failure Cardiology business Anti-Arrhythmia Agents medicine.drug |
| Zdroj: | Revista Española de Cardiología (English Edition). 73:368-375 |
| ISSN: | 1885-5857 |
| DOI: | 10.1016/j.rec.2019.09.004 |
| Popis: | Introduction and objectives Ivabradine is an inhibitor of the If channel, the main determinant of the pacemaker function of the sinus node. The drug has been approved for the treatment of angina and heart failure. There is some evidence of its role as an inhibitor of atrial-ventricular node (AVN) conduction. The aim of the BRAKE-AF project is to assess ivabradine use for rate control in atrial fibrillation (AF). Methods A multicenter, randomized, parallel, open-label, noninferiority phase III clinical trial will be conducted to compare ivabradine vs digoxin in 232 patients with uncontrolled permanent AF despite beta-blockers or calcium channel blockers. The primary efficacy endpoint is the reduction in daytime heart rate measured by 24-hour Holter monitoring at 3 months. This clinical trial will be supported by an electrophysiological study of the effect of ivabradine on the action potential of the human AVN. To do this, an experimental model will be used with Chinese hamster ovarium cells transfected with the DNA encoding the expression of the t channels involved in this action potential and recording of the ionic currents with patch clamp techniques. Results New data will be obtained on the effect of ivabradine on the human AVN and its safety and efficacy in patients with permanent AF. Conclusions The results of the BRAKE-AF project might allow inclusion of ivabradine within the limited arsenal of drugs currently available for rate control in AF. Clinical trial registration: http://www.clinicaltrials.gov . Identifier: NCT03718273 . |
| Databáze: | OpenAIRE |
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