Ivabradine in the treatment of postural tachycardia syndrome (POTS), a single center experience
- 20 September 2017
- journal article
- Published by Wiley in Pacing and Clinical Electrophysiology
- Vol. 40 (11), 1242-1245
- https://doi.org/10.1111/pace.13182
Abstract
Ivabradine is a selective If channel blocker that reduces heart rate without affecting other cardiovascular functions. In case reports and case series, it was shown to improve symptoms in patients with postural tachycardia syndrome (POTS). This retrospective study examined patients who were diagnosed with POTS and received ivabradine as part of their treatment. Forty-nine patients (47 females, 95.9%) received ivabradine. The average age was 35.1 ± 10.35 years. The most common symptoms were palpitations and lightheadedness and both improved significantly, 88.4% and 76.1% response rate, respectively. A total of 38 patients reported improvement in their symptoms. In addition, ivabradine resulted in an objective decrease in sitting and standing heart rate (78.1 ± 10.7 vs 72.5 ± 7.6, P-value: 0.01) and (107.4 ± 14.1 vs 95.1 ± 13.7, P-value: < 0.001), respectively, with no significant change in blood pressure. The most common reported side effect was luminous phenomena/visual brightness occurring in nine patients. However, none of the patients stopped ivabradine due to side effects. Our study shows that ivabradine is likely to be effective in treating patients with POTS. Nearly 78% of our cohort reported a significant improvement in symptoms with no major adverse effects reported. A future randomized, placebo-controlled trial is warranted.Keywords
This publication has 6 references indexed in Scilit:
- Effects of intermittent intravenous saline infusions in patients with medication—refractory postural tachycardia syndromeJournal of Interventional Cardiac Electrophysiology, 2017
- The Effect of Ivabradine on the Heart Rate and Sympathovagal Balance in Postural Tachycardia Syndrome PatientsRambam Maimonides Medical Journal, 2015
- 2015 Heart Rhythm Society Expert Consensus Statement on the Diagnosis and Treatment of Postural Tachycardia Syndrome, Inappropriate Sinus Tachycardia, and Vasovagal SyncopeHeart Rhythm, 2015
- Ivabradine in treatment of sinus tachycardia mediated vasovagal syncopeEP Europace, 2013
- Single centre experience of ivabradine in postural orthostatic tachycardia syndromeEP Europace, 2010
- Postural Tachycardia SyndromeCirculation, 2008