From the Guidelines
Ivabradine is a recommended treatment for patients with symptomatic inappropriate sinus tachycardia (IST) and postural orthostatic tachycardia syndrome (POTS), a form of supraventricular tachycardia (SVT), as it has been shown to reduce heart rate and improve symptoms in these patients. The benefits of ivabradine in patients with SVT are supported by several studies, including a small randomized crossover trial that demonstrated a significant reduction in daytime heart rate and improvement in exercise tolerance and symptoms in patients with IST 1. Additionally, the 2020 ESC guidelines for the management of patients with SVT recommend ivabradine, alone or in combination with beta-blockers, in symptomatic patients with IST and POTS 1.
Some of the key benefits of ivabradine in patients with SVT include:
- Reduction in heart rate: Ivabradine has been shown to reduce heart rate in patients with IST and POTS, which can help to improve symptoms and quality of life.
- Improvement in exercise tolerance: Ivabradine has been shown to improve exercise tolerance in patients with IST, which can help to improve overall physical function and quality of life.
- Reduction in symptoms: Ivabradine has been shown to reduce symptoms such as palpitations, shortness of breath, and fatigue in patients with SVT.
The recommended dose of ivabradine for patients with SVT is typically 2.5-5 mg twice daily, titrated up to 7.5 mg twice daily as needed. Common side effects of ivabradine include phosphenes (visual brightness), bradycardia, and atrial fibrillation, so regular monitoring is recommended, especially during dose titration. Overall, ivabradine is a useful treatment option for patients with SVT who are symptomatic and have not responded to other treatments.
From the Research
Trials Showing Benefits of Ivabradine in Patients with SVT
- The study 2 discusses the off-label utilization of ivabradine in pediatric patients with supraventricular tachycardia (SVT) and highlights its efficacy in treating treatment-resistant (refractory) SVT.
- In the study 3, ivabradine demonstrated favorable efficacy and safety results in patients under 6 months of age with heart failure or SVT.
- Although the studies 4 and 5 focus on the treatment of inappropriate sinus tachycardia, they show that ivabradine is effective in reducing heart rate and symptoms, which could be beneficial for patients with SVT.
- The review 6 highlights the evidence for the use of ivabradine in heart failure, stable ischemic heart disease, and inappropriate sinus tachycardia, but does not specifically focus on SVT.
Key Findings
- Ivabradine appears to be a safe and well-tolerated medication that can induce adequate suppression of SVT, complete reversal to sinus rhythm, and effective enhancement of left ventricular function 2.
- Ivabradine demonstrated significant reduction of mean resting heart rate and improvement of symptoms in patients with inappropriate sinus tachycardia 4, 5.
- The efficacy and safety of ivabradine in patients under 6 months of age with heart failure or SVT were favorable, with significant reduction of heart rate and improvement of symptoms 3.