The Efficacy of Ivabradine Alone, Metoprolol Alone and Combination of Ivabradine and Metoprolol in Reducing Heart Rate Among Patients Undergoing Computed Tomography Coronary Angiography

Abstract

Objectives: to determine the efficacy of Ivabradine alone, Metoprolol alone and Combination of Ivabradine and Metoprolol in reducing heart rate among patients undergoing Computed Tomography Coronary Angiography (CTCA). Methodology: it was a randomized controlled trial comprised of 200 patients. Patients undergoing CTCA having heart rates greater than 80 bpm were divided into three groups. Group A was given Ivabradine and a placebo, Group B received Metoprolol and placebo while Group C was administered with Ivabradine and Metoprolol an hour prior to the scan. The scan was carried under similar situations. Heart rate and variability was recorded before and during the scan. Results: The mean heart rate variability and mean reduction in heart rate of Group A was 3.13±1.01 and 19.02±2.05 respectively. The mean heart rate variability and mean reduction in heart rate of Group B was 4.27±1.08 and 12.11±2.45 respectively. While, the mean heart rate variability and mean reduction in heart rate of Group C was 1.88±0.42 and 25.03±2.74 respectively. Conclusion: Ivabradine is an effective and safe drug for reducing heart rate in patients having CTCA, especially among patients who are unable to tolerate calcium channel blockers and beta blockers owing to their side effects.

Keywords: Ivabradine, Metoprolol, Computed tomography coronary angiography, heart rate reduction, heart rate variability.