Comparative efficacy of ivabradine and beta-blockers in the treatment of tachycardia in patients after COVID-19

Abstract

Aim. To assess the changes of heart rate (HR), exercise tolerance and quality of life in patients after coronavirus disease 2019 (COVID-19) during treatment with ivabradine monotherapy or in combination with beta-blockers (BB) compared with BB monotherapy.Material and methods. This randomized comparative study included 90 patients discharged from a university hospital after an acute COVID-19. The main group (n=60) received, in addition to standard therapy, ivabradine monotherapy or in combination with BB, while the control one (n=30) — standard therapy in combination with BB. The follow-up period lasted 24 weeks. Statistical processing was performed using the STATISTICA 8.0 program. The level of statistical significance was p<0,05.Results. There was a significant decrease in heart rate, an increase in physical activity, as well as an improvement in the quality of life in both groups. In the ivabradine group, significantly lower heart rates (71,2±4,1 vs 73,9±5,1 bpm (p=0,015)), significantly higher increase in physical activity (80 (60; 135) vs 65 m (40; 100) (p=0,017)) and quality of life (35 (27; 45) vs 30 (26; 36) points (p=0,03)) was revealed.Conclusion. It has been shown that ivabradine and beta-blockers can be used in post-COVID-19 tachycardia. Ivabradine monotherapy or in combination with beta-blockers causes a more pronounced decrease in heart rate compared to beta-blocker monotherapy, accompanied by a significant improvement in exercise tolerance and quality of life in this category of patients.