Ivabradine: A Novel Drug to Control Heart of Patients Undergoing CT Coronary Angiography

Journal Title: Scholars Journal of Applied Medical Sciences - Year 2014, Vol 2, Issue 1

Abstract

Heart rate control is crucial for diagnostic accuracy and proper image quality of CTCA. A lower heart rate reduces coronary artery movement artifacts by increasing the length of diastolic phase, thereby improving image quality as blood stay longer in vessels. Despite wide spread use of β-blockers ,it has been difficult to achieve target heart rates in patients undergoing CTCA. Ivabradine is a novel purely negative chronotropic drug which acts on sinus node &decreases heart rate without significant hemodynamic effects or impairment of cardiac conduction. Our study assessed the efficacy of ivabradine on image quality of CT coronary angiography (CTCA) and compared it with β- blockers. We randomized 100 consecutive patients undergoing CTCA to receive either of the two premedication protocols: oral β-blockers or ivabradine. Images were scored in terms of image quality of the coronary artery segments using a 5-point grading scale. Ivabradine achieved better heart rate reduction & also required less additional pre study doses of rate controlling drugs. CTCA image quality with ivabradine group had 95% diagnostically accepted coronary segments imaging compared to 90% with the β – blocker group. β- blocker significantly lowered both systolic and diastolic blood pressure, while ivabradine did not. Ivabradine is an attractive alternate to β- blocker for reduction of heart rate in patients undergoing CTCA and had an excellent safety profile. Keywords: Ivabradine, 64-slice Computed Tomography Coronary Angiography, Heart rate control,β- blocker, Image quality: CTCA, low side effect, CAD.

Authors and Affiliations

Dr. Narendra Patel, Dr. Pramod Sakhi, Dr. Sonali Jain, Dr. Siddhant Jain, Dr Kailash Patel, Dr. Kaushlendra Soni

Keywords

Heart rate control is crucial for diagnostic accuracy and proper image quality of CTCA. A lower heart rate reduces coronary artery movement artifacts by increasing the length of diastolic phase thereby improving image quality as blood stay longer in vessels. Despite wide spread use of β-blockers it has been difficult to achieve target heart rates in patients undergoing CTCA. Ivabradine is a novel purely negative chronotropic drug which acts on sinus node &decreases heart rate without significant hemodynamic effects or impairment of cardiac conduction. Our study assessed the efficacy of ivabradine on image quality of CT coronary angiography (CTCA) and compared it with β- blockers. We randomized 100 consecutive patients undergoing CTCA to receive either of the two premedication protocols: oral β-blockers or ivabradine. Images were scored in terms of image quality of the coronary artery segments using a 5-point grading scale. Ivabradine achieved better heart rate reduction & also required less additional pre study doses of rate controlling drugs. CTCA image quality with ivabradine group had 95% diagnostically accepted coronary segments imaging compared to 90% with the β – blocker group. β- blocker significantly lowered both systolic and diastolic blood pressure while ivabradine did not. Ivabradine is an attractive alternate to β- blocker for reduction of heart rate in patients undergoing CTCA and had an excellent safety profile. Keywords: Ivabradine 64-slice Computed Tomography Coronary Angiography Heart rate control β- blocker Image quality: CTCA low side effect CAD.

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  • EP ID EP374285
  • DOI -
  • Views 114
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How To Cite

Dr. Narendra Patel, Dr. Pramod Sakhi, Dr. Sonali Jain, Dr. Siddhant Jain, Dr Kailash Patel, Dr. Kaushlendra Soni (2014). Ivabradine: A Novel Drug to Control Heart of Patients Undergoing CT Coronary Angiography. Scholars Journal of Applied Medical Sciences, 2(1), 171-175. https://europub.co.uk/articles/-A-374285