Ivabradine for Rate Control in Permanent Atrial Fibrillation

Atrial Fibrillation Clinical Trial

Official title: Ivabradine for Rate Control in Permanent Atrial Fibrillation

Status Completed

Clinical Trial Summary

Ivabradine may be useful as a rate controlling agent in atrial fibrillation without negative effects on hemodynamics and inotropy. The objective in this proof of concept study is to investigate the hypothesis that ivabradine will slow the ventricular response in patients with permanent atrial fibrillation and previously-implanted pacemakers.

Clinical Trial Description

In a simple cross-over study, the investigators will evaluate the impact of oral Ivabradine on exercise treadmill test, percent pacing as stored in pacemaker diagnostics, and 6 minute walk test.

Aim/Hypotheses

• To determine if the addition of Ivabradine to baseline cardiac medications slows mean and maximum heart rates in permanent atrial fibrillation

• Ivabradine will lower mean and maximum heart rates on treadmill exercise test, without lowering blood pressure

• Ivabradine will increase percent pacing, and lower rates over time as shown on pacemaker diagnostic data

• Ivabradine will improve exertional symptoms and exercise tolerance due to atrial fibrillation as measured by the Borg's scale during a six-minute walk test.

Study Design

1. Patients with permanent atrial fibrillation will undergo baseline exercise treadmill test, measurement of heart rates and percent pacing from pacemaker diagnostics, and a 6 minute walk test with symptomatic assessment of dyspnea using the Borg's scale score.

2. Oral Ivabradine will be started at 5 mg twice daily, and up-titrated to a maximum dose of 7.5 mg twice daily at 7 days if percent pacing has not increased significantly or rates have not slowed more than 20bpm.

3. Exercise treadmill test, measurement of heart rates and percent pacing from pacemaker diagnostics, and a 6 minute walk test with symptomatic assessment of dyspnea using the Borg's scale score will be repeated at 2 weeks. ;

Related Conditions & MeSH terms

• Atrial Fibrillation
• Atrial Fibrillation, Persistent

• NCT number: NCT03987204
• Study type: Interventional
• Source: Yale University
• Status: Completed
• Phase: Phase 1
• Start date: June 15, 2019
• Completion date: September 17, 2019