Cardiac Electrophysiology And Heart Failure Practice Test

Which statement best describes Ivabradine use in heart failure management?

Used when EF <= 35% and resting HR >= 70 bpm in sinus rhythm, after optimizing beta-blockers It treats acute decompensated heart failure It is a first-line diuretic It raises resting heart rate

Correct Answer:

Used when EF <= 35% and resting HR >= 70 bpm in sinus rhythm, after optimizing beta-blockers

Explanation:

Ivabradine works by selectively inhibiting the funny current (If) in the sinoatrial node, which slows the heart rate without changing blood pressure or contractility. In chronic heart failure with reduced ejection fraction, reducing a persistently high resting heart rate has been shown to improve symptoms and reduce hospitalizations, provided the patient is in sinus rhythm and already on optimized guideline-directed medical therapy with beta-blockers. That’s why the best description is using ivabradine when the ejection fraction is ≤35% and the resting heart rate is still at least 70 bpm in sinus rhythm, after beta-blockers have been optimized. It’s not used for acute decompensation, it’s not a diuretic, and it does not raise the resting heart rate—it lowers it.

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