The purpose of this study is to determine the role of ivabradine in cardiac resynchronization recipients with an unsatisfactory percentage biventricular pacing. The study protocol 60 patients with heart failure NYHA (New York Heart Association) II-IV treated with optimal medical therapy as clinically indicated who received CRT-D device more than 3 months ago. Patients with biventricular pacing \<95% will and heart rate \<70 at rest and \>50% of heart rate in device memory \>70 will receive ivabradine. The minimal follow-up of patients in the study will be at least six months.
Approximately 30% of CRT recipients do not respond to therapy. One of the causes ot that is unsatisfactory percentage of biventricular pacing. Patients may loose biventricular pacing because of inadequate sinus tachycardia. Ivabradine may prevent inadequate sinus tachycardia and improve quality of live of CRT recipients. According to current guidelines ivabradine is recommended in patients with symptomatic heart failure with heart rate at rest \>70. The hypothesis of this study is that ivabradine may increase percentage of biventricular pacing in CRT recipients who have unsatisfactory percentage of biventricular pacing and \>50% of heart rate in device memory \>70.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
TREATMENT
Masking
NONE
Enrollment
60
Ivabradine 5 mg twice a day or 7,5 mg twice a day
1st Department of Cariology of Medcial University of Warsaw
Warsaw, Masovian Voivodeship, Poland
Percentage of biventricular pacing >95%
Time frame: 6 months
Percentage of biventricular pacing >98%
Time frame: 6 months
Time to first inappropriate shock
Time frame: 6 months
change of mean heart rate compared with baseline
Time frame: 6 months
Cardiovascular hospitalization
Time frame: 6 months
The change between baseline and final echocardiographic parameters
Time frame: 6 months
The assessment of quality of life (SF36)
Time frame: 6 months
The change between baseline and final NYHA class
Time frame: 6 months
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