A Case of Cardiomyopathy Induced by Inappropriate Sinus Tachycardia and Cured by Ivabradine

We present the case of a 67-year-old woman with cardiomyopathy induced by inappropriate sinus tachycardia (IST) and a particularly high average heart rate. The patient was resistant and/or intolerant to treatment with conventional rate-slowing medications. We used ivabradine-a specific sinus node If current inhibitor-and successfully lowered the heart rate ( 33 beats per minute mean heart rate decrease). Symptoms, systolic function, and heart rate variability parameters recovered dramatically. No side effect was noted. We suggest that ivabradine-evaluated in trials to treat stable angina-should be considered as a second-line treatment in patients with very symptomatic and refractory IST. ( PACE 2009; 32: 942-944)