Status:

UNKNOWN

Efficacy and Safety on Heart Rate Control With Ivabradine on Cardiogenic Shock

Lead Sponsor:

Hospital Universitario Ramon y Cajal

Conditions:

Cardiogenic Shock

Eligibility:

All Genders

18+ years

Phase:

PHASE4

Brief Summary

This is a randomized 1:1 blinded study that evaluate in acute left heart failure-cardiogenic shock patients if ivabradine treatment can reduce pulmonary wedge pressure, without inducing a significant ...

Eligibility Criteria

Inclusion

  • Patients aged ≥ 18 years, with acute heart failure due to left ventricular systolic dysfunction (LVEF ≤ 40%) in sinus rhythm, baseline HR ≥ 90 bpm, with signs of low peripheral perfusion with indication for intravenous inotropic treatment (catecholamines: dobutamine , adrenaline, dopamine or noradrenaline) and admitted to the Cardiological Intensive Care Unit.
  • Pharmacological treatment and stable hemodynamic situation in the 4 hours before inclusion.
  • Pulmonary wedge pressure ≥ 18 mm Hg and systolic blood pressure \> 90 mm Hg.
  • Patient's signature on the consent form.

Exclusion

  • Previous treatment with ivabradine (\< 48 hours).
  • Known hypersensitivity to ivabradine.
  • Cardiac rhythm different from sinus rhythm.
  • Unstable cardiac rhythm due to paroxysmal atrial fibrillation or atrial flutter, very frequent ventricular or supraventricular premature beats, ventricular tachycardia, 2nd or 3rd degree atrioventricular (AV) block.
  • Severe chronic renal failure (estimated glomerular filtration rate ≤15 ml / min) or on chronic treatment with dialysis.
  • QT interval higher than 450 ms.
  • Sepsis as a probable mechanism of tachycardia and hypotension.
  • Need for urgent cardiac surgery, planned within 72 hours of possible inclusion.
  • Severe aortic stenosis or severe valvular disease that requires surgical correction.
  • Patient must not have received an IV bolus of furosemide immediately before the baseline hemodynamic assessment.
  • Severe hepatic insufficiency.
  • Patient must not be participating in another clinical trial.
  • Concomitant use of potent CYP3A4 inhibitors.
  • Acute anemia or hypovolemia uncorrected.
  • Pregnancy.

Key Trial Info

Start Date :

May 1 2018

Trial Type :

INTERVENTIONAL

Allocation :

ESTIMATED

End Date :

October 1 2019

Estimated Enrollment :

22 Patients enrolled

Trial Details

Trial ID

NCT03437369

Start Date

May 1 2018

End Date

October 1 2019

Last Update

February 19 2018

Active Locations (1)

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1

Hospital Universitario Ramón y Cajal

Madrid, Spain, 28034