PMC8368123_01
Echocardiography of patient #1 prior to treatment with ivabradine. (A) A moderate mitral regurgitation and a severely dilated left ventricle were observed on echocardiography. (B) Liver ultrasound revealed dilated inferior vena cava and hepatic veins.
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F2
Echocardiography was repeated, it showed worsened LV dilatation and severe LV systolic dysfunction (EF was around 20%), and moderate mitral regurgitation (see Figure 2).
ECGs of patient #1 pre- and post-ivabradine. (A) ECG revealing atrial tachycardia. (B) ECG revealing sinus rhythm (ECG speed: 25 mm/s, and sensitivity: 10 mm/mv). As discussed, this patient was successfully treated with ivabradine, she reverted from atrial tachycardia to sinus rhythm after receiving an adequate course of ivabradine.
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F3
Figure 3 shows the patient's ECG pre- and post-ivabradine.
ECGs of patient #2 pre- and post-ivabradine. (A) ECG revealing atrial tachycardia. (B) ECG revealing sinus rhythm (ECG speed: 25 mm/s, and sensitivity: 10 mm/mv). This patient was reverted adequately to sinus rhythm with combined amiodarone and ivabradine.
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F4
ECG was consistent with atrial tachycardia (Figure 4).
PMC8368123_02
ECGs of patient #3 pre- and post-ivabradine. (A) ECG showing incessant atrial tachycardia. (B) ECG showing sinus rhythm few hours after ivabradine initiation (ECG speed: 25 mm/s, and sensitivity: 10 mm/mv). This initial response to ivabradine was not maintained. As a result, the patient was switched to amiodarone.
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F5
Two hours after this first dose, she reverted to sinus rhythm (Figure 5).