Cappato IST
Clinical Efficacy of Ivabradine in Patients with Inappropriate Sinus Tachycardia
Patient / Population Intervention / Exposition Comparaison Critère de jugement
In 21 patients with symptomatic inappropriate sinus tachycardia, ivabradine eliminated most symptoms and lowered heart rate at rest, on standing and during exertion compared with placebo.
N
21
Schéma
Double-blind, placebo-controlled crossover RCT
Critère
Elimination of symptoms attributable to inappropriate sinus tachycardia
Pertinence
3
RésultatMore than 70 % of symptoms eliminated (relative risk 0.25; 95 % CI 0.18–0.34; p<0.001), with complete elimination in 47 %. Resting heart rate fell from 88 to 76 bpm (p=0.011).
Cappato R, Castelvecchio S, Ricci C, et al. J Am Coll Cardiol. 2012;60(15):1323-1329. 10.1016/j.jacc.2012.06.031
Discussion et critique
Very small, single-centre and short, with a subjective primary endpoint and no beta-blocker comparator — a proof of concept rather than a definitive trial. It is nevertheless the only randomised placebo-controlled evidence in inappropriate sinus tachycardia and is the entire basis of the ivabradine recommendation.