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Endocrine, Metabolic & Immune Disorders - Drug Targets

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ISSN (Print): 1871-5303
ISSN (Online): 2212-3873

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Case Report

Ivabradine for Uncontrolled Sinus Tachycardia in Thyrotoxic Cardiomyopathy - Case Report

Author(s): Amit Frenkel*, Yoav Bichovsky, Natan Arotsker, Limor Besser, Ben-Zion Joshua, Merav Fraenkel, Doron Zahger and Moti Klein

Volume 23, Issue 7, 2023

Published on: 19 January, 2023

Page: [992 - 995] Pages: 4

DOI: 10.2174/1871530323666221214141205

Price: $65

Abstract

Background: Beta-blockers, mainly propranalol, are usually administered to control heart rate in patients with thyrotoxicosis, especially when congestive heart failure presents. However, when thyrotoxicosis is not controlled, heart rate may be difficult to control even with maximal doses of propranolol. This presentation alerts physicians to the possibility of using ivabradine, a selective inhibitor of the sinoatrial pacemaker, for the control of heart rate.

Case Presentation: We present a 37-year-old woman with thyrotoxicosis and congestive heart failure whose heart rate was not controlled with a maximal dose of beta blockers during a thyroid storm. The addition of ivabradine, a selective inhibitor of the sinoatrial pacemaker, controlled her heart rate within 48 hours.

Conclusion: Ivabradine should be considered in patients with thyrotoxicosis, including those with heart failure, in whom beta blockers are insufficient to control heart rate.

Keywords: Thyrotoxicosis, congestive heart failure, heart rate, ivabradine, sinus tachycardia, thyrotoxic cardiomyopathy.

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Graphical Abstract

[1]
De Leo, S.; Lee, S.Y.; Braverman, L.E. Hyperthyroidism. Lancet, 2016, 388(10047), 906-918.
[http://dx.doi.org/10.1016/S0140-6736(16)00278-6] [PMID: 27038492]
[2]
Grais, I.M.; Sowers, J.R. Thyroid and the heart. Am. J. Med., 2014, 127(8), 691-698.
[http://dx.doi.org/10.1016/j.amjmed.2014.03.009] [PMID: 24662620]
[3]
Osuna, P.M.; Udovcic, M.; Sharma, M.D. Hypothyroidism and the heart. Methodist DeBakey Cardiovasc. J., 2017, 13(2), 60-63.
[http://dx.doi.org/10.14797/mdcj-13-2-60] [PMID: 28740583]
[4]
MacDonald, E.A.; Rose, R.A.; Quinn, T.A. Neurohumoral control of sinoatrial node activity and heart rate: Insight from experimental models and findings from humans. Front. Physiol., 2020, 11, 170.
[http://dx.doi.org/10.3389/fphys.2020.00170] [PMID: 32194439]
[5]
Dahl, P.; Danzi, S.; Klein, I. Thyrotoxic cardiac disease. Curr. Heart Fail. Rep., 2008, 5(3), 170-176.
[http://dx.doi.org/10.1007/s11897-008-0026-9] [PMID: 18752767]
[6]
Idrose, A.M. Acute and emergency care for thyrotoxicosis and thyroid storm. Acute Med. Surg., 2015, 2(3), 147-157.
[http://dx.doi.org/10.1002/ams2.104] [PMID: 29123713]
[7]
Tankeu, A.T.; Azabji-Kenfack, M.; Nganou, C.N.; Ngassam, E.; Kuate-Mfeukeu, L.; Mba, C.; Dehayem, M.Y.; Mbanya, J.C.; Sobngwi, E. Effect of propranolol on heart rate variability in hyperthyroidism. BMC Res. Notes, 2018, 11(1), 151.
[http://dx.doi.org/10.1186/s13104-018-3224-x] [PMID: 29471876]
[8]
Davies, C.H.; Davia, K.; Bennett, J.G.; Pepper, J.R.; Poole-Wilson, P.A.; Harding, S.E. Reduced contraction and altered frequency response of isolated ventricular myocytes from patients with heart failure. Circulation, 1995, 92(9), 2540-2549.
[http://dx.doi.org/10.1161/01.CIR.92.9.2540] [PMID: 7586355]
[9]
Sattar, Y.; Neisani Samani, E.; Zafrullah, F.; Latchana, S.; Patel, N.B. Ivabradine in congestive heart failure: Patient selection and perspectives. Cureus, 2019, 11(4), e4448.
[PMID: 31205834]
[10]
Ponikowski, P.; Voors, A.A.; Anker, S.D.; Bueno, H.; Cleland, J.G.F.; Coats, A.J.S.; Falk, V.; González-Juanatey, J.R.; Harjola, V.P.; Jankowska, E.A.; Jessup, M.; Linde, C.; Nihoyannopoulos, P.; Parissis, J.T.; Pieske, B.; Riley, J.P.; Rosano, G.M.C.; Ruilope, L.M.; Ruschitzka, F.; Rutten, F.H.; van der Meer, P. 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. Eur. Heart J., 2016, 37(27), 2129-2200.
[http://dx.doi.org/10.1093/eurheartj/ehw128] [PMID: 27206819]
[11]
Ferrari, G.; Mazzuero, A.; Agnesina, L.; Bertoletti, A.; Lettino, M.; Campana, C.; Peter, J. Schwartz, Luigi Tavazzi Favourable effects of heart rate reduction with intravenous administration of ivabradine in patients with advanced heart failure. Clinical Trial Eur J Heart Fail., 2008, 10(6), 550-5.
[12]
Alam, ST.; Zaman, J. Case study of thyrotoxic cardiomyopathy. BMJ Case Rep., 2019, 12(8)

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