Why do I use ivabradine in my patients?

Ivabradine inhibits sinus node IF channels and lowers the heart rate. It is used in patients with sinus rhytm and heart rate of ≥70/min, who despite the optimal treatment failed to achieve the correct one. In the trials, ivabradine significantly reduced the mortality due to heart failure (26%, p = 0.014) and the risk of hospitalization due to exacerbation of heart failure (18%). Due to neutral influence on hemodynamic parameters and inotropic effects, ivabradine can be administered in patients with elevated heart rate who do not achieve the target dose of β-blockers. Despite the undoubted benefits and clear ESC recommendations, ivabradine is still used in too few patients with HFrEF.