Ivabradine is indicated in the management of

Ivabradine This 'pure' hea rate lowering antianginal drug has been introduced recently. mech of action:- The only significant action of ivabradine is blockade of cardiac pacemaker (sino-atrial) cell 'f' channels, which are 'funny' cation channels that open during early pa of slow diastolic (phase 4) depolarization. The resulting inward current (If) determines the slope of phase 4 depolarization. Selective blockade of If current by ivabradine results in hea rate reduction without any other electrophysiological or negative inotropic or negative lucitropic (slowing of myocardial relaxation) effect. Hea rate reduction decreases cardiac O2 demand and prolongation of diastole tends to improve myocardial perfusion (O2 supply). Accordingly, in clinical trials, ivabradine has been found to improve exercise tolerance in stable angina and reduce angina frequency. Indications:- Used in chronic stable angina in patients with sinus rhythm. Ref:- kd tripathi;pg num:-554