title: Treatment of inappropriate sinus tachycardia with ivabradine.
abstract: BACKGROUND
  Inappropriate sinus tachycardia (IST) often causes palpitations, dyspnea, and exercise intolerance, that are generally treated with beta blockers and non-dihydropyridine calcium-channel antagonists. Ivabradine, a selective inhibitor of cardiac pacemaker If current, has recently emerged as an effective and safe alternative to conventional drugs for IST.
  
  
  METHODS
  We performed a systematic overview of clinical studies on the therapeutic yield of ivabradine in patients with inappropriate sinus tachycardia, published in MEDLINE database from January 2000 to March 2015.
  
  
  RESULTS
  Overall, five case reports were found, all showing efficacy of ivabradine in subjects affected by IST. Eight non-randomized clinical studies demonstrated short- and medium-term safety and efficacy of ivabradine administration in IST, also in adjunction to or in comparison with metoprolol. One double-blind randomized crossover study also showed that ivabradine is superior to placebo for heart rate (HR) reduction and symptoms control in patients affected by IST.
  
  
  CONCLUSIONS
  Ivabradine is effective and safe in short- and medium-term treatment of IST. However, long-term follow-up studies and randomized studies comparing ivabradine with beta blockers are still lacking.
authors.affiliation: Division of Cardiology, Policlinic Casilino, ASL RMB, Via Casilina 1049, Rome, Italy.|Cardiovascular, Respiratory, Nephrologic and Geriatrics Sciences Department, Umberto I Hospital, Sapienza University of Rome, Rome, Italy.
authors.forename: Martino
authors.initials: M
authors.lastname: Annamaria
authors.affiliation: Arrhythmia and Electrophysiology II Center, Humanitas Gavazzeni Clinics, Bergamo, Italy.
authors.forename: Pier Paolo
authors.initials: PP
authors.lastname: Lupo
authors.affiliation: Arrhythmia and Electrophysiology II Center, Humanitas Gavazzeni Clinics, Bergamo, Italy.
authors.forename: Sara
authors.initials: S
authors.lastname: Foresti
authors.affiliation: Arrhythmia and Electrophysiology II Center, Humanitas Gavazzeni Clinics, Bergamo, Italy.
authors.forename: Guido
authors.initials: G
authors.lastname: De Ambroggi
authors.affiliation: Division of Cardiology, Policlinic Casilino, ASL RMB, Via Casilina 1049, Rome, Italy.
authors.forename: Ermenegildo
authors.initials: E
authors.lastname: de Ruvo
authors.affiliation: Division of Cardiology, Policlinic Casilino, ASL RMB, Via Casilina 1049, Rome, Italy.
authors.forename: Luigi
authors.initials: L
authors.lastname: Sciarra
authors.affiliation: Arrhythmia and Electrophysiology II Center, Humanitas Gavazzeni Clinics, Bergamo, Italy.|Arrhythmia and Electrophysiology Research Center, IRCCS Humanitas Clinical and Research Center, Rozzano, Milan, Italy.
authors.forename: Riccardo
authors.initials: R
authors.lastname: Cappato
authors.affiliation: Division of Cardiology, Policlinic Casilino, ASL RMB, Via Casilina 1049, Rome, Italy. leonardo.calo@tin.it.
authors.forename: Leonardo
authors.initials: L
authors.lastname: Calo
mesh_terms: D001552:Benzazepines / Q000008:administration & dosage*; D002317:Cardiovascular Agents / Q000008:administration & dosage; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D016903:Drug Monitoring / Q000379:methods; D019317:Evidence-Based Medicine; D006339:Heart Rate / Q000187:drug effects*; D006801:Humans; D064428:Hyperpolarization-Activated Cyclic Nucleotide-Gated Channels / Q000037:antagonists & inhibitors*; D000077550:Ivabradine; D013616:Tachycardia, Sinus / Q000175:diagnosis* / Q000188:drug therapy*; D016896:Treatment Outcome
chemical_list: D001552:Benzazepines; D002317:Cardiovascular Agents; D064428:Hyperpolarization-Activated Cyclic Nucleotide-Gated Channels; D000077550:Ivabradine
keywords: Inappropriate sinus tachycardia; Ivabradine; Tachy-cardiomyopathy