What is your experience of the use of Ivabradina drug in Asymptomatic degenerative moderate -severe Aortic Stenosis with or without concomitant CAD, to reduce hospitalization for HF and prevent a systolic and diastolic dysfunction?
I don't think use of ivabradine will provide any additional benefit in these cases.
If mod-sever aortic stenosis causes HF, then surgery is indicated, otherwise Ivabriden has no place in such condition
I thank my colleagues for their very active discussion! I agree that the moderate severe symptomatic aortic stenosis for clinical (dyspnea or angina) or hemodynamics (heart failure) have treatment as surgery or TAVI! but how to act in patients with moderately severe asymptomatic aortic stenosis? my experience with ivabradine is very positive in how often the beta blocker is contraindicated or not tolerated if not minimal dose; Also not having ivabradine inotropic effect and pressure but only chronotropic can also be given to severe stenosis with or without CAD to reduce the incidence of heart failure symptoms and waiting for definitive therapy or in some cases only for palliation (the very elderly or fragile or who do not wish to undergo surgery)
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