Meles Ester, Carbone Claudio, Maggiolini Stefano, Moretti Paolo, DE Carlini Caterina C, Gentile Gaetano, Gnecchi-Ruscone Tomaso
Division of Cardiology, Cardiovascular Department, S. Leopoldo Mandic Hospital, Merate, Italy.
Division of Cardiology, Mater Domini Hospital, Castellanza, Italy.
J Cardiovasc Electrophysiol. 2015 May;26(5):565-8. doi: 10.1111/jce.12636. Epub 2015 Mar 18.
Ivabradine is indicated in cardiac failure and ischemia to reduce sinus rate by inhibition of the pacemaker I(f) current in sinoatrial node. We report a case of an 18-year-old woman with left atrial tachyarrhythmia resistant to several antiarrhythmic drugs and to electric cardioversion who responded only to ivabradine, which significantly reduced heart rate without abolishing the arrhythmia itself. An ectopic focus in the ostium of left pulmonary veins was found and the patient was successfully ablated. We suggest that ivabradine might be therefore useful in the treatment of supraventricular tachyarrhythmias due to an enhanced automaticity.
伊伐布雷定适用于心力衰竭和缺血患者,通过抑制窦房结起搏细胞的I(f)电流来降低窦性心律。我们报告了一例18岁女性患者,患有对多种抗心律失常药物及电复律均耐药的左房快速性心律失常,该患者仅对伊伐布雷定有反应,伊伐布雷定显著降低了心率,但未消除心律失常本身。发现左肺静脉口存在一个异位起搏点,该患者最终成功接受了消融治疗。因此,我们认为伊伐布雷定可能对治疗因自律性增强所致的室上性快速性心律失常有用。