[Efficacy of therapy with bisoprolol and ivabradine in patients with ischemic heart disease combined with chronic obstructive pulmonary disease assessment of parameters of 24-hour ECG monitoring].

Effect of therapy with 1-adrenoblocker bisoprolol and inhibitor of If channels ivabradine on parameters of 24-hour ECG monitoring (24hECGM) was studied in 64 patients with ischemic heart disease (stable angina) and chronic obstructive pulmonary disease (COPD). At the first stage all patients received bisoprolol. Parameters of external respiration function (ERF) and 24h ECG were registered before and after 4 months of bisoprolol administration. At stage 2 indications were determined for inclusion of ivabradine in the treatment scheme. At the background of therapy with bisoprolol we obtained significant lowering of heart rate (HR) both during day and night, as well as significant diminution of magnitude and duration of ischemic ST depression. In 44% of patients target HR range was not achieved. This conditioned the necessity to administer ivabradine. Therapy of patients with stable angina and concomitant COPD should begin with cardioselective -adrenoblockers (bisoprolol). Incorporation of inhibitor of If channels ivabradine in the treatment scheme is indicated if during treatment with -adrenoblockers average 24 hour HR according to data of 24hECGM exceeds 70 beats/min and deterioration of bronchial conductance according to ERF data occurs.