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Single centre experience of ivabradine in postural orthostatic tachycardia syndrome

Lookup NU author(s): Dr Claire McDonald, Dr James FrithORCiD, Professor Julia NewtonORCiD


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Aims Postural orthostatic tachycardia syndrome (POTS) is associated with tachycardia on orthostasis. Patients frequently report palpitations, presyncope, and fatigue. Conventional therapy is effective in less than 60%. Case reports suggest ivabradine (a selective sinus node blocker, with no effect on blood pressure) may alleviate POTS-related symptoms. This is a retrospective case-series. Methods and results Postural orthostatic tachycardia syndrome patients prescribed ivabradine were identified from the pharmacy database. Case notes were reviewed and participants completed a symptom assessment tool. Twenty-two patients were identified. Data were available from 20. Eight patients reported reduced tachycardia and fatigue and four reported only reduced tachycardia. The most common reason for discontinuing ivabradine was lack of efficacy (n = 6). Five patients reported side-effects resulting in two discontinuing treatment. Conclusion This retrospective case series indicates that 60% of patients treated with ivabradine report a symptomatic improvement. A randomized controlled trial accessing the efficacy of ivabradine in POTS is indicated, particularly in patients resistant to, or intolerant of, conventional therapy.

Publication metadata

Author(s): McDonald C, Frith J, Newton JL

Publication type: Article

Publication status: Published

Journal: Europace

Year: 2011

Volume: 13

Issue: 3

Pages: 427-430

Print publication date: 09/11/2010

ISSN (print): 1099-5129

ISSN (electronic): 1532-2092

Publisher: Oxford University Press


DOI: 10.1093/europace/euq390


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