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NICE recommends drug to slow sinus rhythm in heart failure



NICE has recommended that a drug to slow heart rate should be made available on the NHS to treat patients with chronic heart failure.

The draft appraisal recommends ivabradine is used in combination with ß-blockers in patients with chronic heart disease whose heart rate is over 75 beats per minute, or if ß-blocker therapy is contraindicated or not tolerated.

Ivabradine was previously only recommended for use in patients suffering from angina, but a study in 2010 showed the drug reduced the number of cardiovascular-related deaths or admissions by 18% in patients with heart failure.

Dr Terry McCormack, a GP in Whitby, said: ‘I am not surprised that NICE is recommending ivabradine in chronic heart failure, because evaluations have shown that it reduces the number of hospitalisations. It is a very safe drug that is effective both in angina and heart failure.

‘There are a substantial number of people who cannot tolerate ß-blockers – for example, people with asthma or those who experience fatigue. But there are also patients who even with the use of ß-blockers have a fast heart rate. For these people, both drugs may be necessary.’

Professor Carole Longson, health technology evaluation centre director at NICE, said: ‘Although the prognosis for people with heart failure has been improving over recent years, largely as a result of better treatments, heart failure can have a significant detrimental impact on quality of life, particularly in terms of affecting a person’s ability to perform everyday tasks.’

 

Wed 26 Sept, central London
*Don’t miss Dr Ahmet Fuat’s practical update on what’s new in heart failure diagnosis and management
*Hear Dr Terry McCormack’s tips on realistic strategies to implement NICE hypertension guidance