Kontakt 2006, 8(2):389-393 | DOI: 10.32725/kont.2006.062

Ivabradine: a new therapeutic perspective in cardiovascular diseaseBiomedicine

Jiří Patočka^1,*, Bohumír Plucar²

¹ University of South Bohemia České Budějovice, Faculty of Health and Social Studies, Department of Radiology and Toxicology

² Masaryk University Brno, Faculty of Medicine, Institute of Medical Ethics

Ivabradine is a novel heart-rate-lowering drug that acts specifically on the sinoatrial node by selectively inhibiting the If current, which is the current prevalently responsible for the slow diastolic depolarization of pacemaker cells. Unlike many rate-lowering agents, ivabradine reduces heart rate in a dose-dependent manner both at rest and during exercise without producing any negative inotropic or vasoconstrictor effect. The bradycardic effect of ivabradine is proportional to the resting heart rate, such that the effect tends to plateau. Because ivabradine also binds to hyperpolarization, voltage-gated channels which carry the Ih current in the eye, transient, dose-dependent changes of the electroretinogram resulting in mild to moderate visual side effects may occur in approximately 15% of patients exposed to ivabradine. Ivabradine does not cross the cerebrovascular brain barrier and therefore, has no effect on the Ih current in central nervous system neurons.1 The safety of ivabradine was assessed in a development program that enrolled over 3,500 patients and 800 healthy volunteers in 36 countries from Europe, North and South America, Africa, Asia and Australia, 1,200 of whom being exposed to ivabradine for over 1 year. Ivabradine was associated with a good safety profile during its clinical development and its safety will be furthermore assessed by postmarketing surveillance and during on-going clinical trials. Ivabradine is the first selective and specific If inhibitor, which received marketing authorization in 27 European countries for the symptomatic treatment of chronic stable angina pectoris in patients with normal sinus rhythm who have a contraindication or intolerance of beta-blockers.

Keywords: angina pectoris; ivabradine; bradycardia; heart rate-lowering agent; f-channel

Published: December 15, 2006  Show citation