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BRIEF RESEARCH REPORT article

Front. Pharmacol.
Sec. Cardiovascular and Smooth Muscle Pharmacology
Volume 16 - 2025 | doi: 10.3389/fphar.2025.1502375

Ivabradine in treatment of symptomatic heart failure and supraventricular tachycardias in patients under six months of age

Provisionally accepted
Laura Gomez Ganda Laura Gomez Ganda 1Carlos Javier Parramon Teixido Carlos Javier Parramon Teixido 1*Gemma Giralt-García Gemma Giralt-García 2Cristina Fernández-García Cristina Fernández-García 3Queralt Ferrer-Menduiña Queralt Ferrer-Menduiña 2Maria Josep Cabañas-Poy Maria Josep Cabañas-Poy 1
  • 1 Pharmacy Department, Vall d'Hebron University Hospital, Barcelona, Catalonia, Spain
  • 2 Pediatric Cardiology Unit, Vall d'Hebron University Hospital, Barcelona, Catalonia, Spain
  • 3 Neonatology Department, Vall d'Hebron University Hospital, BARCELONA, Spain

The final, formatted version of the article will be published soon.

    Background. Although heart failure (HF) and supraventricular tachycardias (SVT) are associated with high morbidity and mortality in pediatrics, especially, in children under six months; the efficacy of available treatments is limited, requiring the use of off-label therapies. The aim of the study is to investigate the efficacy, dosage, and safety of off-label ivabradine in patients under six months of age with HF or SVT. Methods. Retrospective observational study, which included patients under six months of age with HF or SVT who received ivabradine between January 2020 - May 2024. Demographic, clinical, and treatment-related variables were collected. Response variables were established according to indication, HF: heart rate (HR) and left ventricular ejection fraction (LVEF); SVT: HR. Results.Thirteen patients (nine women) with a median age of 1.4 (1-4) months were included. Ivabradine was discontinued in five of the seven HF patients due to resolution of HF, control of HR, and improvement of LVEF. One patient discontinued ivabradine because of bradycardia. In the SVT group, four of the seven patients discontinued ivabradine after the resolution of tachyarrhythmia and improvement of HR. Two patients experienced bradycardia but did not require treatment discontinuation. HR reduction was statistically significant in both groups. In HF, the median initial ivabradine dose was 0.06 mg/kg/day and the maintenance dose was 0.2 mg/kg/day. In SVT, the initial and maintenance doses were 0.1 mg/kg/day and 0.24 mg/kg/day, respectively. Conclusions. Ivabradine demonstrated favorable efficacy and safety results in patients under six months of age with HF or SVT.

    Keywords: Heart Failure, ivabradine, Pediatrics, Tachycardia, atrial tachycardia, Ectopic Atrial Tachycardia, supraventricular tachycardia, Junctional ectopic tachycardia

    Received: 26 Sep 2024; Accepted: 27 Jan 2025.

    Copyright: © 2025 Gomez Ganda, Parramon Teixido, Giralt-García, Fernández-García, Ferrer-Menduiña and Cabañas-Poy. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Carlos Javier Parramon Teixido, Pharmacy Department, Vall d'Hebron University Hospital, Barcelona, Catalonia, Spain

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.