[Heart rate control in patients with sepsis and septic cardiomyopathy: the role of Ivabradine].

Tachycardia is an independent risk factor for mortality of patients with sepsis and multiple organ dysfunction syndrome (MODS), and has attracted extensive attention in recent years. Ivabradine, a specific blocker of hyperpolarization-activated cyclic nucleotide-gated (HCN) channel in sinoatrial node, is capable of inducing heart rate reduction (HRR) via binding specific sites of the channel and promotes ventricular filling because of prolongation of the diastolic period. Ivabradine has no negative effect on inotropic contractility, conductivity, and systemic vascular resistance. While Ivabradine has recently shown its beneficial effects in diverse randomized controlled trials on heart failure, this medicine may be a potential option to treat tachycardia in patients with sepsis and septic cardiomyopathy (SCM). Preliminary findings demonstrate that Ivabradine can remarkably lower heart rate and improve hemodynamic stability in patients with sepsis. In addition, Ivabradine has been reported to ameliorate microcirculation perfusion and suppress the inflammatory response. This review discusses the effects of Ivabradine on heart rate control in patients with sepsis and SCM.