Martino Annamaria, Rebecchi Marco, Sette Antonella, Cicogna Francesco, Politano Alessandro, Sgueglia Marianna, de Ruvo Ermenegildo, Volterrani Maurizio, Calo' Leonardo
Division of Cardiology, Policlinic Casilino.
Cardiology Department, IRCCS San Raffaele Pisana, Rome, Italy.
J Cardiovasc Med (Hagerstown). 2021 Dec 1;22(11):892-900. doi: 10.2459/JCM.0000000000001203.
The aim of our study was to compare ivabradine versus bisoprolol in the short-term and long-term treatment of inappropriate sinus tachycardia.
From this prospective, parallel-group, open-label study, consecutive patients affected by inappropriate sinus tachycardia received ivabradine or bisoprolol and were evaluated with Holter ECG, ECG stress test, European Heart Rhythm Association score and Minnesota Living With Heart Failure Questionnaire at baseline, after 3 and 24 months.
Overall, 40 patients were enrolled. Baseline parameters were comparable in the ivabradine and bisoprolol subgroups. Two patients had transient phosphenes with ivabradine and two others interrupted the drug after 3 months as they planned to become pregnant. Eight individuals treated with bisoprolol experienced hypotension and weakness, which caused drug discontinuation in five of them. Ivabradine was superior to bisoprolol in reducing Holter ECG mean heart rate (HR) and mean HR during daytime at short- and long-term follow-up. Moreover, ivabradine but not bisoprolol significantly reduced Holter ECG mean HR during night-time as well as maximal and minimal HR and significantly increased the time duration and maximal load reached at ECG stress test. The quality of life questionnaires significantly improved in both subgroups.
This study suggests that ivabradine is better tolerated than bisoprolol and seems to be superior in controlling the heart rate and improving exercise capacity in a small population of individuals affected by inappropriate sinus tachycardia during a short-term and long-term follow-up.
我们研究的目的是比较伊伐布雷定与比索洛尔在不适当窦性心动过速短期和长期治疗中的效果。
在这项前瞻性、平行组、开放标签研究中，连续入选的不适当窦性心动过速患者接受伊伐布雷定或比索洛尔治疗，并在基线时、3个月和24个月后通过动态心电图、心电图运动试验、欧洲心律协会评分和明尼苏达心力衰竭生活问卷进行评估。
总共纳入了40例患者。伊伐布雷定组和比索洛尔组的基线参数具有可比性。两名使用伊伐布雷定的患者出现短暂的视幻觉，另外两名患者在3个月后因计划怀孕而中断用药。八名接受比索洛尔治疗的患者出现低血压和虚弱，其中五人因此停药。在短期和长期随访中，伊伐布雷定在降低动态心电图平均心率（HR）和白天平均HR方面优于比索洛尔。此外，伊伐布雷定而非比索洛尔能显著降低夜间动态心电图平均HR以及最大和最小HR，并显著增加心电图运动试验达到的持续时间和最大负荷。两个亚组的生活质量问卷评分均显著改善。
本研究表明，在短期和长期随访中，伊伐布雷定的耐受性优于比索洛尔，在控制心率和提高一小部分不适当窦性心动过速患者的运动能力方面似乎更具优势。
