Heart Rate Control in Non-Paroxysmal Atrial Fibrillation. A New Indication for Ivabradine?

Journal of clinical cardiology and cardiovascular therapy Pub Date : 2017-06-03 DOI:10.17554/J.ISSN.2309-6861.2017.04.131

G. Caminiti, Filomena Cacciapuoti, C. Fossati, D. Battaglia, N. Punzo, M. Volterrani

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引用次数: 1

Abstract

Atrial fibrillation (AF) is the most common cardiac arrhythmia and is associated with poor quality of life and high rate of hospitalization in elderly frail patients. In patients with non-paroxysmal AF, optimizing heart rate is often the main goal but available drugs fail to reach heart rate control in about 30% of cases and this often happens because their doses can not be implemented due to side effects. Ivabradine is a pure heart rate lowering agent acting through the inhibition of If current in the sinus atrial cells, and it is widely used for patients with stable angina and chronic heart failure in sinus rhythm. According to very preliminary data, ivabradine shows heart rate lowering proprieties in non-paroxysmal AF when used alone or in association to other heart rate lowering drugs. Interestingly, studies suggest that this seems to translate into clinical benefits such as improvement of exercise tolerance and ejection fraction. However, new trials are needed to confirm the effectiveness and safety of ivabradine in non-paroxysmal AF.

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非阵发性心房颤动的心率控制。伊伐布雷定的新适应症?

房颤(AF)是老年体弱患者最常见的心律失常，与生活质量差、住院率高有关。在非阵发性房颤患者中，优化心率通常是主要目标，但现有药物在约30%的病例中未能达到心率控制，这通常是因为它们的剂量由于副作用而无法实施。伊伐布雷定是一种纯的通过抑制窦房细胞If电流起作用的降心率剂，广泛用于稳定型心绞痛和窦性心律慢性心力衰竭患者。根据非常初步的数据，伊伐布雷定在单独使用或与其他降心率药物联合使用时显示出非阵发性房颤的降心率特性。有趣的是，研究表明，这似乎转化为临床益处，如改善运动耐受性和射血分数。然而，需要新的试验来证实伊伐布雷定治疗非阵发性房颤的有效性和安全性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Journal of clinical cardiology and cardiovascular therapy

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