Skip to main content

Research Repository

Advanced Search

Limited role for ivabradine in the treatment of chronic heart failure

Cullington, D.; Cleland, John G. F.; Cullington, Damien; Goode, Kevin M; Cleland, John G F; Clark, Andrew L


D. Cullington

John G. F. Cleland

Damien Cullington

Profile Image

Dr Kevin Goode
Research Systems Project Manager / Business Analyst

John G F Cleland

Andrew L Clark


ObjectiveTo quantify the proportion of patients attending a community heart failure clinic with left ventricular systolic impairment who might be suitable for ivabradine therapy.BackgroundHigh resting heart rate is an important and potentially modifiable risk factor in patients with heart failure. The SHIFT study suggested that ivabradine was beneficial when added to conventional treatment including a beta-blocker in heart failure patients in sinus rhythm whose resting heart rates remained 70 beats per minute (bpm) or greater and who had worse than moderate left ventricular impairment.Methods and ResultsThe primary cohort included 2211 patients with a left ventricular ejection fraction (LVEF) of 50% or less. Patients were seen at baseline, then reviewed at 4 and 12 months. 'Suitability' for ivabradine was assessed as: LVEF 35% or less, sinus rhythm and a resting heart rate of 70 bpm or greater. The proportion of patients who were 'suitable' for ivabradine therapy fell from 19.4% (n=429) at baseline, to 14.1% (n=185) at 4 months and finally 9% (n=82) by the 12-month clinic visit. The proportion fell to 5.3% (n=48) if only patients with New York Heart Association class I symptoms and/or no beta-blocker therapy were excluded.ConclusionsAfter uptitration of heart failure medications, the number of patients 'suitable' for ivabradine therapy was small. First and foremost, beta-blocker therapy should be commenced and titrated. The decision to add ivabradine should be made after allowing adequate time to uptitrate conventional medical therapy


Cullington, D., Goode, K. M., Cleland, J. G. F., & Clark, A. L. (2011). Limited role for ivabradine in the treatment of chronic heart failure. Heart, 97(23), 1961-1966.

Journal Article Type Article
Acceptance Date Aug 4, 2011
Online Publication Date Sep 13, 2011
Publication Date Dec 1, 2011
Deposit Date Nov 13, 2014
Journal Heart
Print ISSN 1355-6037
Electronic ISSN 1468-201X
Publisher BMJ Publishing Group
Peer Reviewed Peer Reviewed
Volume 97
Issue 23
Pages 1961-1966
Keywords Cardiology and Cardiovascular Medicine
Public URL