Left Ventricular Failure Pak Armed Forces Med J 2020; 70 (6): 1839-42 1839 ROLE OF HEART RATE REDUCTION WITH IVABRADINE IN LEFT VENTRICULAR FAILURE Safia Batool, Jamal Waris, Muhammad Usman Sajid, Shazia Nisar*, Imran Khan**, Hina Mushtaq*** Combined Military Hospital Jhelum/National University of Medical Sciences (NUMS) Pakistan, *Pak Emirates Military Hospital/National University of Medical Sciences (NUMS) Rawalpindi Pakistan, **Combined Military Hospital Peshawar/National University of Medical Sciences (NUMS) Pakistan, ***Rehman Medical Institute, Peshawar Pakistan ABSTRACT Objective: To compare mean heart rate reduction in Ivabradine and placebo group in left ventricular failure patients. Study Design: Quasi experimental study. Place and Duration of Study: Study was conducted at Combined Military Hospital, Kharian, from Jul 2018 to Dec 2018. Methodology: Sixty four patients participated in the study. They were randomly divided into two groups of 32 each. One group was given Tab Ivabradine (10 mg twice a day) while second group received a placebo for a period of 4 weeks. After 4 weeks each patient was evaluated and heart rate, systolic and diastolic blood pressure were recorded. Mann-whitney U test selected to compare heart rate and ages of both groups t- test used to compare systolic and diastolic blood pressure among both groups. Chi-square test used to determine the association of heart rate between two groups. A p-value ≤0.05 was considered significant. Results: Median (IQR) heart rate was significantly lower in Ivabradine group 58.3 (4) as compared to placebo 64.1(1) (p<0.01). Systolic blood pressure (132.8 ± 3.6) was significantly lower in ivabradine group as compared to placebo group (137.1 ± 4.5) (p<0.01). Difference in diastolic blood pressure was insignificant in both groups (p= 0.55). There was a significant association between heart rate of 55-60 beats per minute and ivabradine use (p<0.01). Conclusion: Ivabradine is safe and efficative drug in reducing heart rate and systolic blood pressure for patients suffering from left ventricular failure. Early detection and management of left ventricular failure with ivabradine use leads to better prognosis of the disease. Keywords: Heart rate, Ivabradine, Left ventricular failure. INTRODUCTION Heart failure is worldwide public health issue with an estimated prevalence of 23 million worldwide 1 . Prevalence of heart failure in United States is 5.8 million 2 . American Heart Association defined heart failure as complex clinical syndro- me as a result of functional and structural cardiac diseases leading towards failures of ventricle ability (filling and ejecting blood) 3 . Left ventricular failure refers to left ventricle dysfunction leading towards insufficient blood delivery to vital body organs 4 . Left ventricular heart failure is classified into i) heart failure (HF) with preserved ejection fraction (over 50%), ii) HF with reduced ejection fraction (<40%) and iii) HF with mid range ejection fraction (41-49%) 5 . Most common etiologies for left ventricular failure are ischemic heart diseas and hypertension. Prevale- nce of ischemis heart disease in Pakistan is 26.9% leading towards left ventricular failure 6 . Left ven- tricular hypertrophy also leads to left ventricular failure. Smoking, diabetes mellitus, obesity, life style and male gender are important risk factors for left ventricular failure 7 . Pathophysiology of left ventricular failure includes multiple mechanisms. Poorly controlled hypertension is responsible for increased cardiac workload and after load resulting towards hyper- trophy. In initial stage, hypertrophy act as comp- ensatory mechanism and help in maintaining This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Correspondence: Dr Safia Batool, Village Ghura Jattan Post Office Nathwala, The Dina Distt, Jhelum Pakistan Received: 30 Mar 2020; revised received: 22 Jun 2020; accepted: 16 Sep 2020 safiabatool203@yahoo.com Original Article Open Access