Background: Ivabradine has a pure heart rate reduction. However, the use of
ivabradine remains limited due to the conflicting evidence of its safety and
Purpose: To determine the efficacy and safety of ivabradine compared to
control in subjects with Heart failure (HF).
Sources: Medline, Embase, Ovid and the Cochrane
Central Register of Controlled Trials from inception through June 2018.
Selection: Peer-reviewed, randomized controlled
trials of Ivabradine versus control in patients with heart failure with or
without low ejection fraction.
Extraction: Two investigators independently
extracted data from each eligible study and assessed the risk of bias of
Synthesis: Six trials with 17886 patients were
included. There was no significant difference among Ivabradine treated group versus
control in lowering all-cause mortality, cardiovascular mortality or hospital
readmission. Ivabradine had an increase in the mean difference in the
percentage of ejection fraction (EF) by 3% as compared with control.
Bradycardia, phosphenes and blurred vision were significantly higher with
ivabradine by 4 and 5 times as compared with control.
Conclusion: Administration of Ivabradine to adults with HF with or without low
EF significantly improved the ejection fraction. However, there was no
significant impact on mortality and re-admission rates
heart failure, systematic review, meta-analysis.