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Targeted heart rate control using the funny current inhibitor ivabradine to reduce morbidity in patients undergoing noncardiac surgery: study protocol for a phase 2a, triple-blind, placebo-controlled randomised trial.
BJA Open
March 2025
Faculty of Medicine and Dentistry, William Harvey Research Institute, Queen Mary University of London, London, UK.
Background: Myocardial injury is strongly associated with excess morbidity and mortality after noncardiac surgery. Higher heart rate may result in perioperative myocardial injury through demand-supply mismatch. Alternatively, higher heart rates may reflect autonomic dysfunction that promotes myocardial injury independently of heart rate.
View Article and Find Full Text PDFHeart Rate Reduction and the Prognosis of Heart Failure Focused on Ivabradine.
J Clin Med
February 2025
Department of Cardiovascular Medicine, Toho University Faculty of Medicine, 6-11-1 Omori-nishi, Ota-ku, Tokyo 143-8541, Japan.
Cardioprotective medications referred to as the fantastic four are used to treat heart failure (HF). Additionally, ivabradine can also be used if the heart rate (HR) is elevated. An elevated HR is a prognostic factor in HF patients, as well as in the general population.
View Article and Find Full Text PDFInappropriate Sinus Tachycardia in Athletes: Could Nutraceuticals Play a Role?
J Cardiovasc Dev Dis
February 2025
Department of Cardiovascular Disease, University of L'Aquila, 67100 L'Aquila, Italy.
Inappropriate sinus tachycardia (IST) is a syndrome characterized by unexpectedly fast and prolonged sinus rates at rest or with minimal physical activity. Epidemiologic characteristics are uncertain, but most patients are young and female. When IST occurs in athletes, its management (controlling symptoms and reducing heart rate) can present additional challenges.
View Article and Find Full Text PDFIvabradine exposures reported to United States poison centers 2015-2023.
Clin Toxicol (Phila)
February 2025
Department of Emergency Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.
Introduction: Ivabradine was approved for use in the United States in 2015 for the management of heart failure. It acts through inhibition of sodium channels found in cardiac myocytes (the "funny" pacemaker current, I), which reduces heart rate without significantly affecting inotropy.
Methods: We queried the National Poison Data System for reported ivabradine exposures from April 15, 2015-December 31, 2023.
HCN4 in the atrioventricular node.
Heart Rhythm
February 2025
Experimental Cardiology, Amsterdam UMC, Meibergdreeg 9, Amsterdam, 1105AZ, The Netherlands,; Heart failure & arrythmias, Amsterdam Cardiovascular sciences, Amsterdam, The Netherlands. Electronic address:
The hyperpolarization-activated cyclic nucleotide-gated channel 4 (HCN4) drives the funny current (I) in cardiac pacemaker regions. Its involvement in sinoatrial node pacemaker generation is well-known, but its function in the atrioventricular (AV) node (AVN) has not intensively been studied. HCN4 is expressed in the AVN and its expression within the AVN seems similar across mammalian species with HCN4 presence in the inferior nodal extensions, compact node, and atrioventricular bundle.
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