alexa Ivabradine: Just another New Pharmacological Option for Heart Rate Control?
ISSN: 2155-9880

Journal of Clinical & Experimental Cardiology
Open Access

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Review Article

Ivabradine: Just another New Pharmacological Option for Heart Rate Control?

Andres Ricardo Perez Riera1, Luiz Carlos de Abreu1, Vitor E. Valenti1,2*, Fernando A. L. Fonseca1, Marcelo Ferreira1, Luiz Carlos M. Vanderlei3, Celso Ferreira Filho1, Carlos B. de Mello Monteiro4, Modesto Leite Rolim Neto5, Luciano M. R. Rodrigues1 and Celso Ferreira1
1Departamento de Morfologia e Fisiologia, Faculdade de Medicina do ABC, Santo André, SP, Brasil
2Departamento de Patologia, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil
3Departamento de Fisioterapia, Faculdade de Ciência e Tecnologia, UNESP, Presidente Prudente, SP, Brasil
4Escola de Artes, Ciência e Humanidades da Universidade de São Paulo, São Paulo, SP, Brasil
5Universidade Federal do Ceará, Cariri, CE, Brasil
Corresponding Author : Vitor E. Valenti
Departamento de Morfologia e Fisiologia
Faculdade de Medicina do ABC, Av. Príncipe de Gales
821, 09060-870, Santo André, SP, Brasil
Tel: +55 (11) 4993-5403
E-mail: [email protected]
Received: September 10, 2011; Accepted: November 19, 2011; Published: November 23, 2011
Citation: Riera ARP, de Abreu LC, Valenti VE, Fonseca FAL, Ferreira M, et al. (2011) Ivabradine: Just another New Pharmacological Option for Heart Rate Control? J Clinic Experiment Cardiol S4:001. doi:10.4172/2155-9880.S4-001
Copyright: © 2011 Riera ARP, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
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Abstract

Ivabradine (IVB) is a heart rate lowering agent that acts via selective inhibition of the pacemaker funny current in sinoatrial nodal P cells, thus, reducing heart rate at rest and during exercise with minimal effect on myocardial contractility, blood pressure, and intracardiac conduction. IVB exerts no effect on external respiratory function parameters and it may also play a role in patients with concurrent chronic obstructive pulmonary disease. This property constitutes an important advantage over β-blockers. IVB acts by reducing the heart rate in a mechanism different from β-blockers, calcium channel blockers or late sodium channel blockers, three commonly prescribed antianginal drugs. As clinical trials have shown, it is remarkably well-tolerated and offers an alternative for patients who cannot take β-blockers. The combination of IVB and atenolol at commonly used doses in patients with chronic stable angina produced additional efficacy with no untoward effect on safety or tolerability. Additionally, side effects are rare and largely limited to a luminous phenomenon or phosphenes. This sensation is thought to be due to a block of Ih in the retina, a current very similar to cardiac If channels. IVB is contraindicated in patients with sick sinus syndrome or sinus node dysfunction and in patients taking hepatic inhibitors of Cytochrome P450 family 3, subfamily A, polypeptide 4 (abbreviated CYP3A4), with exception of omeprazole or lansoprazole. This review briefly summarizes the main studies regarding this drug.

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