What medication slows heart rate without affecting blood pressure and reduces hospitalization in heart failure?

What medication slows heart rate without affecting blood pressure and reduces hospitalization in heart failure?

• A. Digoxin
• B. Spironolactone
• C. Ivabradine
• D. Carvedilol

Answer: (C)

Ivabradine slows heart rate by selectively blocking the If current in the sinoatrial node, the brain’s natural pacemaker. This reduces the rate of diastolic depolarization, so the heart beats more slowly but its contractility and blood pressure remain largely unchanged. Slower heart rate improves ventricular filling and lowers myocardial oxygen demand, which helps reduce hospitalizations for heart failure in patients with systolic dysfunction who are in sinus rhythm and have a higher resting heart rate. It’s used as add-on therapy after guideline-directed medical therapy, particularly when beta-blockers alone don’t achieve enough rate control or are not tolerated. It doesn’t work in atrial fibrillation and can cause visual side effects in some. This makes it the best choice for slowing heart rate without lowering blood pressure while effectively reducing HF hospitalizations.

Ivabradine slows heart rate by selectively blocking the If current in the sinoatrial node, the brain’s natural pacemaker. This reduces the rate of diastolic depolarization, so the heart beats more slowly but its contractility and blood pressure remain largely unchanged. Slower heart rate improves ventricular filling and lowers myocardial oxygen demand, which helps reduce hospitalizations for heart failure in patients with systolic dysfunction who are in sinus rhythm and have a higher resting heart rate. It’s used as add-on therapy after guideline-directed medical therapy, particularly when beta-blockers alone don’t achieve enough rate control or are not tolerated. It doesn’t work in atrial fibrillation and can cause visual side effects in some. This makes it the best choice for slowing heart rate without lowering blood pressure while effectively reducing HF hospitalizations.