Efficacy and Safety on Heart Rate Control With Ivabradine on Cardiogenic Shock

Inclusion Criteria: * Patients aged ≥ 18 years, with acute heart failure due to left ventricular systolic dysfunction (LVEF ≤ 40%) in sinus rhythm, baseline HR ≥ 90 bpm, with signs of low peripheral perfusion with indication for intravenous inotropic treatment (catecholamines: dobutamine , adrenaline, dopamine or noradrenaline) and admitted to the Cardiological Intensive Care Unit. * Pharmacological treatment and stable hemodynamic situation in the 4 hours before inclusion. * Pulmonary wedge pressure ≥ 18 mm Hg and systolic blood pressure \> 90 mm Hg. * Patient's signature on the consent form. Exclusion Criteria: * Previous treatment with ivabradine (\< 48 hours). * Known hypersensitivity to ivabradine. * Cardiac rhythm different from sinus rhythm. * Unstable cardiac rhythm due to paroxysmal atrial fibrillation or atrial flutter, very frequent ventricular or supraventricular premature beats, ventricular tachycardia, 2nd or 3rd degree atrioventricular (AV) block. * Severe chronic renal failure (estimated glomerular filtration rate ≤15 ml / min) or on chronic treatment with dialysis. * QT interval higher than 450 ms. * Sepsis as a probable mechanism of tachycardia and hypotension. * Need for urgent cardiac surgery, planned within 72 hours of possible inclusion. * Severe aortic stenosis or severe valvular disease that requires surgical correction. * Patient must not have received an IV bolus of furosemide immediately before the baseline hemodynamic assessment. * Severe hepatic insufficiency. * Patient must not be participating in another clinical trial. * Concomitant use of potent CYP3A4 inhibitors. * Acute anemia or hypovolemia uncorrected. * Pregnancy.