What is Ivabradine?
Ivabradine is a heart rate–lowering medication that works by selectively inhibiting the “funny current” (If) in the heart’s natural pacemaker. Unlike beta-blockers, ivabradine lowers the heart rate without affecting blood pressure or the strength of heart contractions, making it an attractive option for individuals who cannot tolerate beta-blockers. Originally approved for treating heart failure and angina, ivabradine is now being investigated as a treatment for post-COVID conditions, particularly Postural Orthostatic Tachycardia Syndrome (POTS) and persistent sinus tachycardia.
How Ivabradine Helps for Long COVID
- Heart Rate Control – Long COVID patients commonly experience elevated heart rates, especially upon standing (POTS). Ivabradine directly reduces heart rate, which can help decrease symptoms like palpitations, fatigue, and dizziness.
What the Research Says
Several studies have reported positive outcomes using ivabradine in Long COVID and post-COVID POTS patients.
Key literature on Ivabradine and Long COVID
Studies showing positive effects:
- This study examined 55 patients with COVID-related POTS and found that 78% reported significant symptom relief within 7 days of starting ivabradine. Heart rate variability improved significantly, and reductions were seen in minimum, average, and maximum 24-hour heart rates.
- This study compared ivabradine to carvedilol in 24 post-COVID patients with sinus tachycardia. Ivabradine reduced heart rate by 31.5% vs. 18.2% with carvedilol. Additionally, 91.7% of ivabradine users experienced symptom relief, compared to 66.7% in the carvedilol group.
- This case report described a 30-year-old woman with post-COVID tachycardia and suspected myocarditis. Ivabradine effectively reduced her resting heart rate and resolved palpitations when beta-blockers were not an option.
Systematic review:
- This systematic review highlighted ivabradine as a promising option for POTS management, especially in cases where beta-blockers were poorly tolerated, showing reductions in heart rate and improvement in orthostatic symptoms.
Final Thoughts
Ivabradine is gaining attention as a viable treatment for Long COVID patients dealing with tachycardia and POTS. With a good safety profile and growing evidence supporting its efficacy, it may offer relief for patients struggling with debilitating cardiovascular symptoms post-COVID. As always, more large-scale studies are needed to standardize its use, but the current data is encouraging. As a prescription medication, its use must be guided by a medical professional.