Arrhythmic effects of Ivabradine in patients with coronary artery disease

Sani N Murat, Salih Orcan, Ramazan Akdemir, Mehmet Dogan, Emel Kara, Mustafa Balci


Objectives: Ivabradine is the first specific heart rate-lowering agent that has completed clinical development for stable angina pectoris. The aim of the present study was to investigate the effects of ivabradine therapy on P-wave duration, dispersion and QT duration, dispersion in coronary artery disease patients.

Methods and Results: The study population consisted of 21 patients with CAD who have confirmed by coronary angiography previously. Written informed consent was obtained in all patients. Twelve-lead electrocardiogram was recorded for each subject at a rate of 50mm/s on admission and repeated after 1 month ivabradine therapy. QT duration, QT dispertion, maximum and minimum QT duration calculated. Maximum and minimum P wave and P wave dispersion has been calculated. Heart rate was decreased after ivabradine therapy. (75±15 and 63±10, P=0.02).There was no difference between Pmax, Pmin and Pdis values before and after treatment. QTmax value was prolonged after treatment. (410±43 and 431±14, P=0,005) but there was no difference between cQTmax value.(455±38 and 439±21) There was no difference between QTdis and cQTdis values before and after treatment. (44±18 & 49±14; and 49±22 & 48±15). QTmax was prolonged after ivabradine therapy but cQTmax, Pdis, QTdis and cQTdis were not prolonged.

Conclusion: There is no relationship between ivabradine therapy and increased risk of ventricular and atrial arrhythmia in coronary artery disease patient.

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