Ivabradine-Induced Torsade de Pointes in Patients with Heart Failure Reduced Ejection Fraction.

Ivabradine-Induced Torsade de Pointes in Patients with Heart Failure Reduced Ejection Fraction. Int Heart J. 2020 Sep 12;: Authors: Jang JH, Kwon SW, Lee MJ, Ko KY, Park JH, Yoon GS, Choi SH, Beak YS, Park SD, Shin SH, Woo SI, Kim DH, Kwan J Abstract Ivabradine is a selective inhibitor of the sinoatrial node "funny" current, prolonging the slow diastolic depolarization. As it has the ability to block the heart rate selectively, it is more effective at a faster heart rate. It is recommended for the treatment of heart failure reduced ejection fraction in the presence of beta-blocker therapy for the further reduction of the heart rate. However, previous reports have shown the association of Torsade de pointes (TdP) with concurrent use of ivabradine and drugs resulting in QT prolongation or blockage of the metabolic breakdown of ivabradine. In this article, we report two cases of patients with heart failure reduced ejection fraction who developed TdP after ivabradine use. Our report highlights the need to exercise caution with the administration of ivabradine in the presence of a reduced repolarization reserve, such as QT prolongation or metabolic insufficiency. PMID: 32921663 [PubMed - as supplied by publisher]
Source: International Heart Journal - Category: Cardiology Tags: Int Heart J Source Type: research