Trial reportCritical care (London, England)2018
Intravenous ivabradine versus placebo in patients with low cardiac output syndrome treated by dobutamine after elective coronary artery bypass surgery: a phase 2 exploratory randomized controlled trial.
Trial report in Critical care (London, England), 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 3 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
13 citing papers in PubMed, 3 syntheses or guidelines pooled it, 29 citations in OpenAlex.
- Ivabradine use in critical care: a systematic review and metanalysis of cardiogenic and septic shock patients.BMC anesthesiology · 2025Pooled it
- Definitions of low cardiac output syndrome after cardiac surgery and their effect on the incidence of intraoperative LCOS: A literature review and cohort study.Frontiers in cardiovascular medicine · 2022Pooled it
- Pooled it
- Effect of preoperative ivabradine on hemodynamics during elective off-pump CABG.Annals of cardiac anaesthesiaTrial
- Ivabradine in acute care: Revisiting the funny current in critical care context.World journal of critical care medicine · 2025Review
- A Rationale for the Use of Ivabradine in the Perioperative Phase of Cardiac Surgery: A Review.Journal of cardiovascular development and disease · 2025Review
- Dobutamine-induced alternations in cerebral blood flow of healthy adults: a 3D pseudocontinuous arterial spin labeling study.BMC medicine · 2023Article
- Short-Term Results of Ivabradine versus Metoprolol: The Effects on Atrial Fibrillation in Patients Undergoing Off-Pump Coronary Artery Bypass Grafting.Brazilian journal of cardiovascular surgery · 2022Article
- Initiating ivabradine during hospitalization in patients with acute heart failure: A real-world experience in China.Clinical cardiology · 2022Article
- Implications of Doppler Echocardiography-guided Heart Rate Modulation Using Ivabradine.Internal medicine (Tokyo, Japan) · 2021Observational
- Two cases of dilated cardiomyopathy with blood pressure-limited tolerability of cardioprotective agents improved by ivabradine.Journal of cardiology cases · 2021Article
- Implication of Ivabradine in Up-titrating Beta-blocker in a Patient with Advanced Heart Failure.Internal medicine (Tokyo, Japan) · 2021Article
- Hemodynamic effects of ivabradine use in combination with intravenous inotropic therapy in advanced heart failure.Heart failure reviews · 2021Review
Corrections and comments
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Authors and funding
9 authors at 6 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundLow cardiac output syndrome (LCOS) is a severe condition which can occur after cardiac surgery, especially among patients with pre-existing left ventricular dysfunction. Dobutamine, its first-line treatment, is associated with sinus tachycardia. This study aims to assess the ability of intravenous ivabradine to decrease sinus tachycardia associated with dobutamine infused for LCOS after coronary artery bypass graft (CABG) surgery.
methodsIn a phase 2, multi-center, single-blind, randomized controlled trial, patients with left ventricular ejection fraction below 40% presenting sinus tachycardia of at least 100 beats per minute (bpm) following dobutamine infusion for LCOS after CABG surgery received either intravenous ivabradine or placebo (three ivabradine for one placebo). Treatment lasted until dobutamine weaning or up to 48 h. The primary endpoint was the proportion of patients achieving a heart rate (HR) in the 80- to 90-bpm range. Secondary endpoints were invasive and non-invasive hemodynamic parameters and arrhythmia events.
resultsNineteen patients were included. More patients reached the primary endpoint in the ivabradine than in the placebo group (13 (93%) versus 2 (40%); P = 0.04). Median times to reach target HR were 1.0 h in the ivabradine group and 5.7 h in the placebo group. Ivabradine decreased HR (112 to 86 bpm, P <0.001) while increasing cardiac index (P = 0.02), stroke volume (P <0.001), and systolic blood pressure (P = 0.03). In the placebo group, these parameters remained unchanged from baseline. In the ivabradine group, five patients (36%) developed atrial fibrillation (AF) and one (7%) was discontinued for sustained AF; two (14%) were discontinued for bradycardia.
conclusionIntravenous ivabradine achieved effective and rapid correction of sinus tachycardia in patients who received dobutamine for LCOS after CABG surgery. Simultaneously, stroke volume and systolic blood pressure increased, suggesting a beneficial effect of this treatment on tissue perfusion.
trial registrationEuropean Clinical Trials Database: EudraCT 2009-018175-14 . Registered February 2, 2010.
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