Metoprolol succinate vs. ivabradine in the treatment of inappropriate sinus tachycardia in patients unresponsive to previous pharmacological therapy

Abstract

Metoprolol and ivabradine exert a similar effect on resting HR in patients with IST. Ivabradine seems to be more effective to relieve symptoms during exercise or daily activity.

2015 ACC/AHA/HRS Guideline for the Management of Adult Patients With Supraventricular Tachycardia: Executive Summary

“…The drug has no other hemodynamic effects aside from lowering the heart rate. As such, it has been investigated for use to reduce the sinus rate and improve symptoms related to IST (85)(86)(87)(88)(89)(90)(91)(92)(93).…”

The Choice Of Optimal Coronary Stents: Is It Possible To Maximize Cost-Effectiveness?

“…There are controversy and a lack of consensus regarding the diagnostic criteria of this entity. It has been recently published in a case series comparing the effect of metoprolol and ivabradine [24] on resting HR and during exercise in IST patients. Ivabradine was more effective to relieve symptoms during exercise or daily activity and was better tolerated.…”

Is There a Role for Ivabradine Beyond its Conventional Use?

“…Cal o et al [22] in a case series that included 18 IST patients demonstrated the effects of ivabradine in reducing HR at the Holter recordings and to increasing the exercise tolerance in stress tests. Still, in another case series comparing the effect of metoprolol and ivabradine on resting HR and during exercise in IST patients, ivabradine was more effective in relieving symptoms during exercise or daily activity and was better tolerated [23].…”