Single centre experience of ivabradine in postural orthostatic tachycardia syndrome
Open Access
- 9 November 2010
- journal article
- research article
- Published by Oxford University Press (OUP) in EP Europace
- Vol. 13 (3), 427-430
- https://doi.org/10.1093/europace/euq390
Abstract
Postural orthostatic tachycardia syndrome (POTS) is associated with tachycardia on orthostasis. Patients frequently report palpitations, presyncope, and fatigue. Conventional therapy is effective in less than 60%. Case reports suggest ivabradine (a selective sinus node blocker, with no effect on blood pressure) may alleviate POTS-related symptoms. This is a retrospective case-series. Postural orthostatic tachycardia syndrome patients prescribed ivabradine were identified from the pharmacy database. Case notes were reviewed and participants completed a symptom assessment tool. Twenty-two patients were identified. Data were available from 20. Eight patients reported reduced tachycardia and fatigue and four reported only reduced tachycardia. The most common reason for discontinuing ivabradine was lack of efficacy (n = 6). Five patients reported side-effects resulting in two discontinuing treatment. This retrospective case series indicates that 60% of patients treated with ivabradine report a symptomatic improvement. A randomized controlled trial accessing the efficacy of ivabradine in POTS is indicated, particularly in patients resistant to, or intolerant of, conventional therapy.Keywords
This publication has 8 references indexed in Scilit:
- Ivabradine: Appropriate treatment for inappropriate sinus tachycardiaHeart Rhythm, 2010
- Treatment of Inappropriate Sinus Tachycardia with Ivabradine in a Patient with Postural Orthostatic Tachycardia Syndrome and a Dual Chamber PacemakerPacing and Clinical Electrophysiology, 2008
- A review of postural orthostatic tachycardia syndromeEP Europace, 2008
- The Newcastle protocols 2008: an update on head-up tilt table testing and the management of vasovagal syncope and related disordersHeart, 2008
- Symptom improvement in postural orthostatic tachycardia syndrome with the sinus node blocker ivabradineEP Europace, 2007
- Postural Orthostatic Tachycardia Syndrome: The Mayo Clinic ExperienceMayo Clinic Proceedings, 2007
- Posturales orthostatisches Tachykardiesyndrom (POTS): Ätiologie, Diagnose und TherapieMedizinische Klinik - Intensivmedizin und Notfallmedizin, 2000
- The Postural Orthostatic Tachycardia Syndrome: A Potentially Treatable Cause of Chronic Fatigue, Exercise Intolerance, and Cognitive Impairment in AdolescentsPacing and Clinical Electrophysiology, 2000