Safety and effectiveness of ivabradine after cardiac transplantation.
BACKGROUND
Heart denervation is the primary cause of sinus tachycardia in transplant recipients. Drugs are usually needed to treat associated symptoms.


OBJECTIVE
To evaluate the safety and effectiveness of the novel I(f) channel antagonist ivabradine to control heart rate after transplantation.


METHODS
Of 316 heart transplant recipients at a single center since 1991, ivabradine was administered in 15 patients, in addition to β-blockers in 4 patients and contraindication to use of β-blocker therapy in the others. A prospective follow-up study was conducted to identify possible adverse effects, tolerance, and drug effects on heart rate and control of symptoms.


RESULTS
Of the 15 patients, 13 were men; overall mean (SD) patient age was 46 (4.6) years. In all patients, treatment was begun after verification of basal heart rate greater than 100 bpm and after other causes of sinus tachycardia had been ruled out. During follow-up of 1.13 (0.3) years, no substantial adverse effects were observed. It was possible to reach the maximum drug dosage in all patients, achieving a reduction in basal heart rate of 33 (6.2) bpm. All patients reported substantial clinical improvement, and demonstrated an increase in functional class.


CONCLUSIONS
Ivabradine is safe, well tolerated, and effective in heart transplant recipients.
U.G. Área del Corazón, Servicio de Cardiologia, Virgen del Rocío University Hospital, Seville, Spain. niemed21@hotmail.com
E
E
Lage-Gallé
N
N
Romero-Rodríguez
J
J
Nevado-Portero
A
A
Guisado-Rasco
M
M
Sobrino-Márquez
M Gonzales-Vargas
MG
Machuca
M
M
Fernández-Quero
A
A
Campos-Pareja
S
S
Ballesteros-Pradas
A
A
Martínez-Martínez
D001552:Benzazepines / Q000009:adverse effects / Q000627:therapeutic use*; D016027:Heart Transplantation; D006801:Humans; D000077550:Ivabradine
D001552:Benzazepines; D000077550:Ivabradine