Abstract
Increased resting heart rate (HR) is an independent marker of increased cardiovascular risk, both in the general population and in patients with various cardiovascular diseases. Pharmacological reduction of HR (e.g., with beta-blockers) reduces the cardiovascular risk.
Ivabradine, a selective sinus node If channel inhibitor, reduces HR without having other effects, such as haemodynamic ones. In the SHIFT trial, HR reduction with ivabradine has been shown to reduce the rate of cardiovascular events in patients with systolic heart failure.
Current recommendations for treatment with ivabradine in systolic heart failure remain fully valid. When using ivabradine in stable angina pectoris, it is necessary to respect the European Medicines Agency recommendations that, in this country, are in full compliance with the valid indication restriction.