Journal article
Ivabradine effects on COVID-19-associated postural orthostatic tachycardia syndrome: a single center prospective study
American journal of cardiovascular disease, Vol.13(3), pp.162-167
01/01/2023
PMCID: PMC10352820
PMID: 37469536
Abstract
Background: A wide range of cardiac arrhythmias were reported in the setting of active infection or as a complication of COVID-19. The main pathophysiology can be attributed to dysautonomia or autonomic nervous system dysfunction. Postural orthostatic tachycardia syndrome (POTS) is a complex, multisystemic disorder affecting usually younger age with tachycardia at rest or with minimal effort being the main symptom. Data regarding the safety and efficacy of ivabradine in POTS treatment is limited to small studies and case reports. Methods: This prospective observational study included a total of 55 COVID-19-associated POTS patients after the exclusion of other causes of tachycardia. Ivabradine 5 mg twice daily was initiated. Re-assessment of patients’ symptoms, heart rate, and heart rate variability (HRV) parameters’ changes after 3 days of ivabradine therapy was done. Results: The mean age of the included patients was 30.5±6.9 years with 32 patients being males (58.2%). 43 of 55 (78%) of the included patients reported significant improvement of the symptoms within 7 days of ivabradine therapy. 24-hour heart rate (minimum, average, and maximum) was significantly lower (
p
-value < 0.0001*, = 0.001*, < 0.0001* consecutively) with a significant difference in HRV time-domain parameters (SDNN, rMSSD) (
p
-value < 0.0001*) after ivabradine therapy. Conclusion: In a prospective study that evaluated the effects of ivabradine in post-COVID-19 POTS, patients treated with ivabradine reported improvement of their symptoms within 7 days of ivabradine treatment with a significant reduction of 24-hour average, minimum, and maximum heart rate, and improvement of HRV time domains parameters. Ivabradine might be a useful option to relieve symptoms of tachycardia in COVID-19 POTS. Further research is required to confirm the safety and efficacy of ivabradine in POTS treatment.
Details
- Title: Subtitle
- Ivabradine effects on COVID-19-associated postural orthostatic tachycardia syndrome: a single center prospective study
- Creators
- Mahmoud Abdelnabi - Internal Medicine Department, Texas Tech University Health Science CenterYehia Saleh - Houston MethodistAshraf Ahmed - Alexandria UniversityJuthipong Benjanuwattra - Internal Medicine Department, Texas Tech University Health Science CenterNatnicha Leelaviwat - Internal Medicine Department, Texas Tech University Health Science CenterAbdallah Almaghraby - Alexandria University
- Resource Type
- Journal article
- Publication Details
- American journal of cardiovascular disease, Vol.13(3), pp.162-167
- PMID
- 37469536
- PMCID
- PMC10352820
- NLM abbreviation
- Am J Cardiovasc Dis
- ISSN
- 2160-200X
- eISSN
- 2160-200X
- Publisher
- e-Century Publishing Corporation
- Number of pages
- 6
- Language
- English
- Date published
- 01/01/2023
- Academic Unit
- Internal Medicine
- Record Identifier
- 9984757161102771
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