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The place of Ivabradine in management of chronic heart failure patient with implanted cardiac resynchronization therapy - case report

Title: The place of Ivabradine in management of chronic heart failure patient with implanted cardiac resynchronization therapy - case report
Authors: Marinova, Zhenya; Tsvetanova, Roksana; Ivanova, Elena; Hristov, Dimitar; Mircheva, Lilyana
Source: Scripta Scientifica Vox Studentium; Vol 2 (2018): Suppl.1. Abstracts of the Sixth Black Sea Symposium for Young Scientists in Biomedicine (BSYSB), April 12-15 2018, Varna; 78 ; 2535-048X ; 2535-0471
Publisher Information: Medical University of Varna
Publication Year: 2018
Collection: Varna Medical University Press: Journals
Subject Terms: heart failure; CRT; Ivabradine; management
Description: Introduction: Heart failure is a syndrome characterized by typical symptoms (e.g. dyspnoea, pretibial oedema, fatigue) caused by structural and/or functional cardiac abnormalities, resulting in reduced cardiac output and/or elevated intracardiac pressures at rest or during stress. It is end-stage of all car­diovascular diseases and due to its wide spread may easily be described as an epidemic of 21st century.Materials and methods: We present a case of 52-year-old male with a history of coronary artery dis­ease who underwent percutaneous coronary intervention due to chest pain with implantation of 2 drug-eluting stents. In 2016 after suffering anterior myocardial infarction he was hospitalized again and another PCI of stent thrombosis of the proximal LAD was performed. During the patient`s hos­pital stay an ejection fraction of 30% and left bundle branch block were established and he devel­oped signs of total HF. The combination of low EF and LBBB lead to the implantation of CRT-D. On 03.2017 he was urgently admitted to II. Cardiology Clinic in UMHAT `St. Marina` with progressive symptoms of CHF. After a correction of therapy and optimization of the CRT-D under ultrasound control the patient had subjective improvement and reduction of swelling. Due to lack of adequate heart rate control after correction of CRT parameters and optimal dose of beta-blocker, Ivabradine was added to patients therapy.Results: The following check-ups showed significant improvement, no symptoms of exacerbated HF, no readmissions due to the condition and NYHA class II-III.Conclusion: Management of HF patients with CRT should follow the same algorithm as in all other HF patients. In cases of sinus rhythm and HR>70/min Ivabradine is a drug of choice for HR control which also improves physical capacity and quality of life. However, despite the availability of numer­ous therapy methods that increase the life expectancy of these patients, the prognosis remains poor.
Document Type: article in journal/newspaper
Language: English
DOI: 10.14748/ssvs.v2i0.4612
Availability: https://journals.mu-varna.bg/index.php/ssvs/article/view/4612; https://doi.org/10.14748/ssvs.v2i0.4612
Rights: Всички публикации наScripta Scientifica Vox Studentium са лицензирани под Creative Commons Attribution 3.0 License. ; All work by Scripta Scientifica Vox Studentium is licensed under a Creative Commons Attribution 3.0 License.
Accession Number: edsbas.9B73CE41
Database: BASE