Cappato IST
Clinical Efficacy of Ivabradine in Patients with Inappropriate Sinus Tachycardia
Doente / População Intervenção / Exposição Comparação Desfecho
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
Desenho
Double-blind, placebo-controlled crossover RCT
Desfecho
Elimination of symptoms attributable to inappropriate sinus tachycardia
Relevância
3
ResultadoMore 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
Discussão e crítica
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.