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A note of caution must be emphasised. Ivabradine, though indicated for chronic heart failure in patients who are clinically stable, is not indicated in acute heart failure where the enhanced heart rate represents cardiac reserve. Indiscriminate use of Ivabradine could destabilise these patients.
Cardiotonic agents are typically employed as short-term and non-routine therapies for heart failure patients. [71] They are specifically reserved for those with contractile dysfunction in the left ventricles (lower chambers of the heart), low cardiac output, and low blood pressure, placing them at risk of inadequate organ perfusion. [72]
Non-dihydropyridines are contraindicated in patients with heart failure with reduced ejection fraction (HFrEF), and second- or third-degree atrioventricular block. [13] Special attention should be given to the coadministration of non-DHP with beta-blockers or ivabradine due to the increased risk of bradycardia. [13]
A resting heart rate of 100 beats per minute or an increase in heart rate of 100 beats per minute with minimal exertion; Excluding any potential secondary causes of sinus tachycardia; Ruling out atrial tachycardias; Palpitations or presyncope (or both) symptoms that have been clearly linked to resting or easily induced sinus tachycardia.
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Carvedilol, sold under the brand name Coreg among others, is a beta blocker medication, that may be prescribed for the treatment of high blood pressure (hypertension) and chronic heart failure with reduced ejection fraction (also known as HFrEF or systolic heart failure).
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