Effects on Outcomes of Heart Rate Reduction by Ivabradine in Patients With Congestive Heart Failure: Is There an Influence of Beta-Blocker Dose?: Findings From the SHIFT (Systolic Heart failure treatment with the If inhibitor ivabradine Trial) Study

Objectives This study used the SHIFT (Systolic Heart failure treatment with the If inhibitor ivabradine Trial) database to assess the impact of background beta-blocker dose on response to ivabradine. Background In systolic heart failure, reduction in relatively high heart rates improves clinical outcomes when achieved with beta-blockers and even more so when the sinus node inhibitor ivabradine also is added. Methods Among patients with systolic heart failure, sinus rhythm, and heart rate greater than or equal to 70 beats/min on recommended background therapy, maximally tolerated beta-blocker doses were subgrouped as no beta-blocker,