Abstract
Heart rate is an important factor affecting, in patients with coronary atherosclerosis, perfusion by the left ventricle and the incidence of myocardial ischemia. Heart rate lowering has been used to reduce the ischemic burden since the 1960s with the advent of beta-blockers.
An alternative approach resulting in heart rate reduction is inhibition of the specific If ion current in the sinus node. Selective If inhibition by ivabradine, the first representative of a newly formed class referred to as sinus node inhibitors or bradines, is a major addition to the spectrum of drugs available for the management of angina