Skip to main content
SpringerLink
Log in

Heart rate reduction in heart failure: ivabradine or beta blockers?

  • Published:
Heart Failure Reviews Aims and scope Submit manuscript

Abstract

Ivabradine, a selective I f current inhibitor, decreasing the heart rate in those with sinus rhythm, has been added to the most recent European guidelines on heart failure. It is indicated in addition to beta blockers in patients with decreased left ventricular ejection fraction and sinus rate of over 70 beats per minute. Several well-designed studies including the BEAUTIFUL and the SHIFT trials demonstrated clear benefits of ivabradine in symptomatic patients, both with angina and with heart failure, with left ventricular systolic dysfunction. The main objective of this review is to provide a comprehensive summary of data on ivabradine, and to discuss the potential role of this new agent in the spectrum of modern therapeutics for heart failure.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Palatini P, Casiglia E, Julius S, Pessina AC (1999) High heart rate: a risk factor for cardiovascular death in elderly men. Arch Intern Med 159(6):585–592

    Article  PubMed  CAS  Google Scholar 

  2. Jouven X, Empana JP, Escolano S, Buyck JF, Tafflet M, Desnos M et al (2009) Relation of heart rate at rest and long-term (>20 years) death rate in initially healthy middle-aged men. Am J Cardiol 103(2):279–283. doi:10.1016/j.amjcard.2008.08.071

    Article  PubMed  Google Scholar 

  3. Kannel WB, Kannel C, Paffenbarger RS Jr, Cupples LA (1987) Heart rate and cardiovascular mortality: the Framingham Study. Am Heart J 113(6):1489–1494

    Article  PubMed  CAS  Google Scholar 

  4. Cucherat M (2007) Quantitative relationship between resting heart rate reduction and magnitude of clinical benefits in post-myocardial infarction: a meta-regression of randomized clinical trials. Eur Heart J 28(24):3012–3019. doi:10.1093/eurheartj/ehm489

    Article  PubMed  Google Scholar 

  5. Packer DL, Bardy GH, Worley SJ, Smith MS, Cobb FR, Coleman RE et al (1986) Tachycardia-induced cardiomyopathy: a reversible form of left ventricular dysfunction. Am J Cardiol 57(8):563–570

    Article  PubMed  CAS  Google Scholar 

  6. Thackray SD, Ghosh JM, Wright GA, Witte KK, Nikitin NP, Kaye GC et al (2006) The effect of altering heart rate on ventricular function in patients with heart failure treated with beta-blockers. Am Heart J 152(4):713 e719-713. doi:10.1016/j.ahj.2006.07.007

    Article  Google Scholar 

  7. Aaronson KD, Schwartz JS, Chen TM, Wong KL, Goin JE, Mancini DM (1997) Development and prospective validation of a clinical index to predict survival in ambulatory patients referred for cardiac transplant evaluation. Circulation 95(12):2660–2667

    Article  PubMed  CAS  Google Scholar 

  8. Poole-Wilson PA, Uretsky BF, Thygesen K, Cleland JG, Massie BM, Ryden L (2003) Mode of death in heart failure: findings from the ATLAS trial. Heart 89(1):42–48

    Article  PubMed  CAS  Google Scholar 

  9. Nul DR, Doval HC, Grancelli HO, Varini SD, Soifer S, Perrone SV et al (1997) Heart rate is a marker of amiodarone mortality reduction in severe heart failure. The GESICA-GEMA Investigators. Grupo de Estudio de la Sobrevida en la Insuficiencia Cardiaca en Argentina-Grupo de Estudios Multicentricos en Argentina. J Am Coll Cardiol 29(6):1199–1205

    Article  PubMed  CAS  Google Scholar 

  10. Kapoor JR, Heidenreich PA (2010) Heart rate predicts mortality in patients with heart failure and preserved systolic function. J Card Fail 16(10):806–811. doi:10.1016/j.cardfail.2010.04.013

    Article  PubMed  Google Scholar 

  11. Thollon C, Bidouard JP, Cambarrat C, Lesage L, Reure H, Delescluse I et al (1997) Stereospecific in vitro and in vivo effects of the new sinus node inhibitor (+)-S 16257. Eur J Pharmacol 339(1):43–51

    Article  PubMed  CAS  Google Scholar 

  12. DiFrancesco D, Camm JA (2004) Heart rate lowering by specific and selective I(f) current inhibition with ivabradine: a new therapeutic perspective in cardiovascular disease. Drugs 64(16):1757–1765

    Article  PubMed  CAS  Google Scholar 

  13. Joannides R, Moore N, Iacob M, Compagnon P, Lerebours G, Menard JF et al (2006) Comparative effects of ivabradine, a selective heart rate-lowering agent, and propranolol on systemic and cardiac haemodynamics at rest and during exercise. Br J Clin Pharmacol 61(2):127–137. doi:10.1111/j.1365-2125.2005.02544.x

    Article  PubMed  CAS  Google Scholar 

  14. Manz M, Reuter M, Lauck G, Omran H, Jung W (2003) A single intravenous dose of ivabradine, a novel I(f) inhibitor, lowers heart rate but does not depress left ventricular function in patients with left ventricular dysfunction. Cardiology 100(3):149–155. doi:10.1159/000073933

    Article  PubMed  CAS  Google Scholar 

  15. Camm AJ, Lau CP (2003) Electrophysiological effects of a single intravenous administration of ivabradine (S 16257) in adult patients with normal baseline electrophysiology. Drugs R D 4(2):83–89

    Article  PubMed  CAS  Google Scholar 

  16. Tendera M, Talajic M, Robertson M, Tardif JC, Ferrari R, Ford I et al (2011) Safety of ivabradine in patients with coronary artery disease and left ventricular systolic dysfunction (from the BEAUTIFUL Holter Substudy). Am J Cardiol 107(6):805–811. doi:10.1016/j.amjcard.2010.10.065

    Article  PubMed  CAS  Google Scholar 

  17. Borer JS, Fox K, Jaillon P, Lerebours G (2003) Antianginal and antiischemic effects of ivabradine, an I(f) inhibitor, in stable angina: a randomized, double-blind, multicentered, placebo-controlled trial. Circulation 107(6):817–823

    Article  PubMed  Google Scholar 

  18. Tardif JC, Ponikowski P, Kahan T (2009) Efficacy of the I(f) current inhibitor ivabradine in patients with chronic stable angina receiving beta-blocker therapy: a 4-month, randomized, placebo-controlled trial. Eur Heart J 30(5):540–548. doi:10.1093/eurheartj/ehn571

    Article  PubMed  CAS  Google Scholar 

  19. De Ferrari GM, Mazzuero A, Agnesina L, Bertoletti A, Lettino M, Campana C et al (2008) Favourable effects of heart rate reduction with intravenous administration of ivabradine in patients with advanced heart failure. Eur J Heart Fail 10(6):550–555. doi:10.1016/j.ejheart.2008.04.005

    Article  PubMed  Google Scholar 

  20. Ceconi C, Cargnoni A, Francolini G, Parinello G, Ferrari R (2009) Heart rate reduction with ivabradine improves energy metabolism and mechanical function of isolated ischaemic rabbit heart. Cardiovasc Res 84(1):72–82. doi:10.1093/cvr/cvp158

    Article  PubMed  CAS  Google Scholar 

  21. Ceconi C, Comini L, Suffredini S, Stillitano F, Bouly M, Cerbai E et al (2011) Heart rate reduction with ivabradine prevents the global phenotype of left ventricular remodeling. Am J Physiol Heart Circ Physiol 300(1):H366–H373. doi:10.1152/ajpheart.01117.2009

    Article  PubMed  CAS  Google Scholar 

  22. Christensen LP, Zhang RL, Zheng W, Campanelli JJ, Dedkov EI, Weiss RM et al (2009) Postmyocardial infarction remodeling and coronary reserve: effects of ivabradine and beta blockade therapy. Am J Physiol Heart Circ Physiol 297(1):H322–H330. doi:10.1152/ajpheart.01337.2008

    Google Scholar 

  23. Busseuil D, Shi Y, Mecteau M, Brand G, Gillis MA, Thorin E et al (2010) Heart rate reduction by ivabradine reduces diastolic dysfunction and cardiac fibrosis. Cardiology 117(3):234–242. doi:10.1159/000322905

    Article  PubMed  CAS  Google Scholar 

  24. Mulder P, Barbier S, Chagraoui A, Richard V, Henry JP, Lallemand F et al (2004) Long-term heart rate reduction induced by the selective I(f) current inhibitor ivabradine improves left ventricular function and intrinsic myocardial structure in congestive heart failure. Circulation 109(13):1674–1679. doi:10.1161/01.cir.0000118464.48959.1c

    Article  PubMed  CAS  Google Scholar 

  25. Fang Y, Debunne M, Vercauteren M, Brakenhielm E, Richard V, Lallemand F et al (2012) Heart rate reduction induced by the if current inhibitor ivabradine improves diastolic function and attenuates cardiac tissue hypoxia. J Cardiovasc Pharmacol 59(3):260–267. doi:10.1097/FJC.0b013e31823e5e01

    Article  PubMed  CAS  Google Scholar 

  26. Milliez P, Messaoudi S, Nehme J, Rodriguez C, Samuel JL, Delcayre C (2009) Beneficial effects of delayed ivabradine treatment on cardiac anatomical and electrical remodeling in rat severe chronic heart failure. Am J Physiol Heart Circ Physiol 296(2):H435–H441. doi:10.1152/ajpheart.00591.2008

    Article  PubMed  CAS  Google Scholar 

  27. Volterrani M, Cice G, Caminiti G, Vitale C, D’Isa S, Perrone Filardi P et al (2011) Effect of Carvedilol, Ivabradine or their combination on exercise capacity in patients with Heart Failure (the CARVIVA HF trial). Int J Cardiol 151(2):218–224. doi:10.1016/j.ijcard.2011.06.098

    Article  PubMed  Google Scholar 

  28. Ekman I, Chassany O, Komajda M, Bohm M, Borer JS, Ford I et al (2011) Heart rate reduction with ivabradine and health related quality of life in patients with chronic heart failure: results from the SHIFT study. Eur Heart J 32(19):2395–2404. doi:10.1093/eurheartj/ehr343

    Article  PubMed  Google Scholar 

  29. Sarullo FM, Fazio G, Puccio D, Fasullo S, Paterna S, Novo S et al (2010) Impact of “off-label” use of ivabradine on exercise capacity, gas exchange, functional class, quality of life, and neurohormonal modulation in patients with ischemic chronic heart failure. J Cardiovasc Pharmacol Ther 15(4):349–355. doi:10.1177/1074248410370326

    Article  PubMed  CAS  Google Scholar 

  30. Fox K, Ford I, Steg PG, Tendera M, Ferrari R (2008) Ivabradine for patients with stable coronary artery disease and left-ventricular systolic dysfunction (BEAUTIFUL): a randomised, double-blind, placebo-controlled trial. Lancet 372(9641):807–816. doi:10.1016/s0140-6736(08)61170-8

    Article  PubMed  CAS  Google Scholar 

  31. Fox K, Ford I, Steg PG, Tendera M, Robertson M, Ferrari R (2009) Relationship between ivabradine treatment and cardiovascular outcomes in patients with stable coronary artery disease and left ventricular systolic dysfunction with limiting angina: a subgroup analysis of the randomized, controlled BEAUTIFUL trial. Eur Heart J 30(19):2337–2345. doi:10.1093/eurheartj/ehp358

    Article  PubMed  CAS  Google Scholar 

  32. Ceconi C, Freedman SB, Tardif JC, Hildebrandt P, McDonagh T, Gueret P et al (2011) Effect of heart rate reduction by ivabradine on left ventricular remodeling in the echocardiographic substudy of BEAUTIFUL. Int J Cardiol 146(3):408–414. doi:10.1016/j.ijcard.2010.10.125

    Article  PubMed  CAS  Google Scholar 

  33. Swedberg K, Komajda M, Bohm M, Borer JS, Ford I, Dubost-Brama A et al (2010) Ivabradine and outcomes in chronic heart failure (SHIFT): a randomised placebo-controlled study. Lancet 376(9744):875–885. doi:10.1016/s0140-6736(10)61198-1

    Article  PubMed  CAS  Google Scholar 

  34. Tardif JC, O’Meara E, Komajda M, Bohm M, Borer JS, Ford I et al (2011) Effects of selective heart rate reduction with ivabradine on left ventricular remodelling and function: results from the SHIFT echocardiography substudy. Eur Heart J 32(20):2507–2515. doi:10.1093/eurheartj/ehr311

    Article  PubMed  CAS  Google Scholar 

  35. Lage-Galle E, Romero-Rodriguez N, Nevado-Portero J, Guisado-Rasco A, Sobrino-Marquez M, Machuca MG et al (2010) Safety and effectiveness of ivabradine after cardiac transplantation. Transplant Proc 42(8):3191–3192. doi:10.1016/j.transproceed.2010.05.125

    Article  PubMed  CAS  Google Scholar 

  36. Doesch AO, Ammon K, Konstandin M, Celik S, Kristen A, Frankenstein L et al (2009) Heart rate reduction for 12 months with ivabradine reduces left ventricular mass in cardiac allograft recipients. Transplantation 88(6):835–841. doi:10.1097/TP.0b013e3181b4e0f5

    Article  PubMed  Google Scholar 

  37. Zhang R, Haverich A, Struber M, Simon A, Pichlmaier M, Bara C (2008) Effects of ivabradine on allograft function and exercise performance in heart transplant recipients with permanent sinus tachycardia. Clin Res Cardiol 97(11):811–819. doi:10.1007/s00392-008-0690-5

    Article  PubMed  CAS  Google Scholar 

  38. Doesch AO, Celik S, Ehlermann P, Frankenstein L, Zehelein J, Koch A et al (2007) Heart rate reduction after heart transplantation with beta-blocker versus the selective If channel antagonist ivabradine. Transplantation 84(8):988–996. doi:10.1097/01.tp.0000285265.86954.80

    Article  PubMed  CAS  Google Scholar 

  39. Zhang R, Bobylev D, Stiefel P, Haverich A, Bara C (2012) Lasting reduction of heart transplant tachycardia with ivabradine is effective and well tolerated: results of 48-month study. Clin Res Cardiol. doi:10.1007/s00392-012-0436-2

  40. McMurray JJ, Adamopoulos S, Anker SD, Auricchio A, Bohm M, Dickstein K et al (2012) ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure 2012: The Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2012 of the European Society of Cardiology. Developed in collaboration with the Heart Failure Association (HFA) of the ESC. Eur Heart J. doi:10.1093/eurheartj/ehs104

  41. Cullington D, Goode KM, Cleland JG, Clark AL (2011) Limited role for ivabradine in the treatment of chronic heart failure. Heart 97(23):1961–1966. doi:10.1136/heartjnl-2011-300041

    Article  PubMed  CAS  Google Scholar 

  42. Castagno D, Petrie MC, Claggett B, McMurray J (2012) Should we SHIFT our thinking about digoxin? Observations on ivabradine and heart rate reduction in heart failure. Eur Heart J 33(9):1137–1141. doi:10.1093/eurheartj/ehs004

    Article  PubMed  CAS  Google Scholar 

  43. DiBianco R, Shabetai R, Kostuk W, Moran J, Schlant RC, Wright R (1989) A comparison of oral milrinone, digoxin, and their combination in the treatment of patients with chronic heart failure. N Engl J Med 320(11):677–683. doi:10.1056/nejm198903163201101

    Article  PubMed  CAS  Google Scholar 

  44. Gullestad L, Wikstrand J, Deedwania P, Hjalmarson A, Egstrup K, Elkayam U et al (2005) What resting heart rate should one aim for when treating patients with heart failure with a beta-blocker? Experiences from the Metoprolol Controlled Release/Extended Release Randomized Intervention Trial in Chronic Heart Failure (MERIT-HF). J Am Coll Cardiol 45(2):252–259. doi:10.1016/j.jacc.2004.10.032

    Article  PubMed  Google Scholar 

  45. Metra M, Torp-Pedersen C, Swedberg K, Cleland JG, Di Lenarda A, Komajda M et al (2005) Influence of heart rate, blood pressure, and beta-blocker dose on outcome and the differences in outcome between carvedilol and metoprolol tartrate in patients with chronic heart failure: results from the COMET trial. Eur Heart J 26(21):2259–2268. doi:10.1093/eurheartj/ehi386

    Article  PubMed  CAS  Google Scholar 

  46. Lechat P, Hulot JS, Escolano S, Mallet A, Leizorovicz A, Werhlen-Grandjean M et al (2001) Heart rate and cardiac rhythm relationships with bisoprolol benefit in chronic heart failure in CIBIS II Trial. Circulation 103(10):1428–1433

    Article  PubMed  CAS  Google Scholar 

  47. Gelbrich G, Edelmann F, Inkrot S, Lainscak M, Apostolovic S, Neskovic AN et al (2012) Is target dose the treatment target? Uptitrating beta-blockers for heart failure in the elderly. Int J Cardiol 155(1):160–166. doi:10.1016/j.ijcard.2011.11.018

    Article  PubMed  Google Scholar 

  48. McAlister FA, Wiebe N, Ezekowitz JA, Leung AA, Armstrong PW (2009) Meta-analysis: beta-blocker dose, heart rate reduction, and death in patients with heart failure. Ann Intern Med 150(11):784–794

    Article  PubMed  Google Scholar 

  49. Flannery G, Gehrig-Mills R, Billah B, Krum H (2008) Analysis of randomized controlled trials on the effect of magnitude of heart rate reduction on clinical outcomes in patients with systolic chronic heart failure receiving beta-blockers. Am J Cardiol 101(6):865–869. doi:10.1016/j.amjcard.2007.11.023

    Article  PubMed  CAS  Google Scholar 

  50. Huang RL, Listerman J, Goring J, Giesberg C, Nading MA, Butler J (2006) Beta-blocker therapy for heart failure: should the therapeutic target be dose or heart rate reduction? Congest Heart Fail 12(4):206–210 (quiz 211-202)

    Article  PubMed  CAS  Google Scholar 

  51. Swedberg K, Komajda M, Bohm M, Borer J, Robertson M, Tavazzi L (2012) Effects on outcomes of heart rate reduction by ivabradine in patients with congestive heart failure: is there an influence of beta-blocker dose?: findings from the SHIFT (systolic heart failure treatment with the I(f) inhibitor ivabradine trial) Study. J Am Coll Cardiol. doi:10.1016/j.jacc.2012.01.020

  52. Cullington D, Goode KM, Clark AL, Cleland JG (2012) Heart rate achieved or beta-blocker dose in patients with chronic heart failure: which is the better target? Eur J Heart Fail. doi:10.1093/eurjhf/hfs060

  53. Nagatsu M, Spinale FG, Koide M, Tagawa H, DeFreitas G, Cooper G et al (2000) Bradycardia and the role of beta-blockade in the amelioration of left ventricular dysfunction. Circulation 101(6):653–659

    Article  PubMed  CAS  Google Scholar 

  54. Guth BD, Heusch G, Seitelberger R, Ross J Jr (1987) Mechanism of beneficial effect of beta-adrenergic blockade on exercise-induced myocardial ischemia in conscious dogs. Circ Res 60(5):738–746

    Article  PubMed  CAS  Google Scholar 

  55. Simonsen S, Ihlen H, Kjekshus JK (1983) Haemodynamic and metabolic effects of timolol (Blocadren) on ischaemic myocardium. Acta Med Scand 213(5):393–398

    Article  PubMed  CAS  Google Scholar 

  56. Ulu N, Henning RH, Goris M, Schoemaker RG, van Gilst WH (2009) Effects of ivabradine and metoprolol on cardiac angiogenesis and endothelial dysfunction in rats with heart failure. J Cardiovasc Pharmacol 53(1):9–17. doi:10.1097/FJC.0b013e318193dfce

    Article  PubMed  CAS  Google Scholar 

  57. Tardif JC, Ford I, Tendera M, Bourassa MG, Fox K (2005) Efficacy of ivabradine, a new selective I(f) inhibitor, compared with atenolol in patients with chronic stable angina. Eur Heart J 26(23):2529–2536. doi:10.1093/eurheartj/ehi586

    Article  PubMed  CAS  Google Scholar 

  58. Parakh N, Chaturvedi V, Kurian S, Tyagi S (2012) Effect of ivabradine vs atenolol on heart rate and effort tolerance in patients with mild to moderate mitral stenosis and normal sinus rhythm. J Card Fail 18(4):282–288. doi:10.1016/j.cardfail.2012.01.001

    Article  PubMed  CAS  Google Scholar 

  59. Colin P, Ghaleh B, Hittinger L, Monnet X, Slama M, Giudicelli JF et al (2002) Differential effects of heart rate reduction and beta-blockade on left ventricular relaxation during exercise. Am J Physiol Heart Circ Physiol 282(2):H672–H679. doi:10.1152/ajpheart.00547.2001

    PubMed  CAS  Google Scholar 

  60. Amosova E, Andrejev E, Zaderey I, Rudenko U, Ceconi C, Ferrari R (2011) Efficacy of ivabradine in combination with Beta-blocker versus uptitration of Beta-blocker in patients with stable angina. Cardiovasc Drugs Ther 25(6):531–537. doi:10.1007/s10557-011-6327-3

    Article  PubMed  CAS  Google Scholar 

  61. Becher PM, Lindner D, Miteva K, Savvatis K, Zietsch C, Schmack B et al (2012) Role of heart rate reduction in the prevention of experimental heart failure: comparison between if-channel blockade and beta-receptor blockade. Hypertension 59(5):949–957. doi:10.1161/hypertensionaha.111.183913

    Article  PubMed  CAS  Google Scholar 

  62. Riesen SC, Schober KE, Cervenec RM, Bonagura JD (2011) Comparison of the effects of ivabradine and atenolol on heart rate and echocardiographic variables of left heart function in healthy cats. J Vet Intern Med 25(3):469–476. doi:10.1111/j.1939-1676.2011.0705.x

    Article  PubMed  CAS  Google Scholar 

  63. Fasullo S, Cannizzaro S, Maringhini G, Ganci F, Giambanco F, Vitale G et al (2009) Comparison of ivabradine versus metoprolol in early phases of reperfused anterior myocardial infarction with impaired left ventricular function: preliminary findings. J Card Fail 15(10):856–863. doi:10.1016/j.cardfail.2009.05.013

    Article  PubMed  CAS  Google Scholar 

  64. Maczewski M, Mackiewicz U (2008) Effect of metoprolol and ivabradine on left ventricular remodelling and Ca2+ handling in the post-infarction rat heart. Cardiovasc Res 79(1):42–51. doi:10.1093/cvr/cvn057

    Article  PubMed  CAS  Google Scholar 

  65. Majewski S, Slomka S, Zielinska-Wyderkiewicz E, Ciebiada M, Gorski P (2012) Heart rate-lowering efficacy and respiratory safety of ivabradine in patients with obstructive airway disease: a randomized, double-blind, placebo-controlled, crossover study. Am J Cardiovasc Drugs 12(3):179–188. doi:10.2165/11597400-000000000-00000

    Article  PubMed  CAS  Google Scholar 

  66. Hauptman PJ, Schwartz PJ, Gold MR, Borggrefe M, Van Veldhuisen DJ, Starling RC et al (2012) Rationale and study design of the INcrease Of Vagal TonE in Heart Failure study: iNOVATE-HF. Am Heart J 163(6):954-962 e951. doi:10.1016/j.ahj.2012.03.021

    Article  Google Scholar 

  67. Li M, Zheng C, Sato T, Kawada T, Sugimachi M, Sunagawa K (2004) Vagal nerve stimulation markedly improves long-term survival after chronic heart failure in rats. Circulation 109(1):120–124. doi:10.1161/01.cir.0000105721.71640.da

    Article  PubMed  Google Scholar 

  68. Sabbah HN, Gupta RC, Imai M, Irwin ED, Rastogi S, Rossing MA et al (2011) Chronic electrical stimulation of the carotid sinus baroreflex improves left ventricular function and promotes reversal of ventricular remodeling in dogs with advanced heart failure. Circ Heart Fail 4(1):65–70. doi:10.1161/circheartfailure.110.955013

    Article  PubMed  Google Scholar 

  69. De Ferrari GM, Crijns HJ, Borggrefe M, Milasinovic G, Smid J, Zabel M et al (2011) Chronic vagus nerve stimulation: a new and promising therapeutic approach for chronic heart failure. Eur Heart J 32(7):847–855. doi:10.1093/eurheartj/ehq391

    Article  PubMed  Google Scholar 

  70. Pfister R, Michels G, Sharp SJ, Luben R, Wareham NJ, Khaw KT (2012) Resting heart rate and incident heart failure in apparently healthy men and women in the EPIC-Norfolk study. Eur J Heart Fail. doi:10.1093/eurjhf/hfs104

  71. Lechat P, Escolano S, Golmard JL, Lardoux H, Witchitz S, Henneman JA et al (1997) Prognostic value of bisoprolol-induced hemodynamic effects in heart failure during the Cardiac Insufficiency BIsoprolol Study (CIBIS). Circulation 96(7):2197–2205

    Article  PubMed  CAS  Google Scholar 

  72. Fox K, Ford I, Steg PG, Tendera M, Robertson M, Ferrari R (2008) Heart rate as a prognostic risk factor in patients with coronary artery disease and left-ventricular systolic dysfunction (BEAUTIFUL): a subgroup analysis of a randomised controlled trial. Lancet 372(9641):817–821. doi:10.1016/s0140-6736(08)61171-x

    Article  PubMed  Google Scholar 

  73. Ahmadi-Kashani M, Kessler DJ, Day J, Bunch TJ, Stolen KQ, Brown S et al (2009) Heart rate predicts outcomes in an implantable cardioverter-defibrillator population. Circulation 120(21):2040–2045. doi:10.1161/circulationaha.108.847608

    Article  PubMed  Google Scholar 

  74. Chonchol M, Goldenberg I, Moss AJ, McNitt S, Cheung AK (2007) Risk factors for sudden cardiac death in patients with chronic renal insufficiency and left ventricular dysfunction. Am J Nephrol 27(1):7–14. doi:10.1159/000098431

    Article  PubMed  Google Scholar 

  75. Opasich C, Rapezzi C, Lucci D, Gorini M, Pozzar F, Zanelli E et al (2001) Precipitating factors and decision-making processes of short-term worsening heart failure despite “optimal” treatment (from the IN-CHF Registry). Am J Cardiol 88(4):382–387

    Article  PubMed  CAS  Google Scholar 

  76. Castagno D, Skali H, Takeuchi M, Swedberg K, Yusuf S, Granger CB et al (2012) Association of heart rate and outcomes in a broad spectrum of patients with chronic heart failure: results from the CHARM (Candesartan in heart failure: assessment of reduction in mortality and morbidity) program. J Am Coll Cardiol 59(20):1785–1795. doi:10.1016/j.jacc.2011.12.044

    Article  PubMed  Google Scholar 

Download references

Conflict of interest

Author has no conflict of interest to disclose.

Author information

Authors and Affiliations

  1. Department of Medicine, University of South Florida, Tampa, FL, USA

    Maya Guglin

Authors
  1. Maya Guglin
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Maya Guglin.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Guglin, M. Heart rate reduction in heart failure: ivabradine or beta blockers?. Heart Fail Rev 18, 517–528 (2013). https://doi.org/10.1007/s10741-012-9347-6

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10741-012-9347-6

Keywords

Search

Navigation