Mukesh A, Sharma A, Kothari N. Ivabradine in acute care: Revisiting the funny current in critical care context. World J Crit Care Med 2025; 14(4): 111054 [DOI: 10.5492/wjccm.v14.i4.111054]
Corresponding Author of This Article
Ankur Sharma, MD, Additional Professor, Consultant, Department of Trauma and Emergency (Anaesthesiology and Critical Care), All India Institute of Medical Sciences, Basni, Phase-2, Jodhpur 342008, Rājasthān, India. ankuranaesthesia@gmail.com
Research Domain of This Article
Critical Care Medicine
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Dec 9, 2025 (publication date) through Dec 9, 2025
Times Cited of This Article
Times Cited (0)
Journal Information of This Article
Publication Name
World Journal of Critical Care Medicine
ISSN
2220-3141
Publisher of This Article
Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
Share the Article
Mukesh A, Sharma A, Kothari N. Ivabradine in acute care: Revisiting the funny current in critical care context. World J Crit Care Med 2025; 14(4): 111054 [DOI: 10.5492/wjccm.v14.i4.111054]
World J Crit Care Med. Dec 9, 2025; 14(4): 111054 Published online Dec 9, 2025. doi: 10.5492/wjccm.v14.i4.111054
Ivabradine in acute care: Revisiting the funny current in critical care context
Arun Mukesh, Ankur Sharma, Nikhil Kothari
Arun Mukesh, Anesthesia and Critical Care, All India Institute of Medical Sciences, Jodhpur 342008, Rājasthān, India
Ankur Sharma, Department of Trauma and Emergency (Anaesthesiology and Critical Care), All India Institute of Medical Sciences, Jodhpur 342008, Rājasthān, India
Nikhil Kothari, Department of Anaesthesia, All India Institute of Medical Sciences, Jodhpur 342008, Rājasthān, India
Author contributions: Mukesh A wrote the initial draft of the manuscript; Sharma A and Kothari N searched the literature and revised the manuscript.
Conflict-of-interest statement: The authors declare no conflict of interest.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ankur Sharma, MD, Additional Professor, Consultant, Department of Trauma and Emergency (Anaesthesiology and Critical Care), All India Institute of Medical Sciences, Basni, Phase-2, Jodhpur 342008, Rājasthān, India. ankuranaesthesia@gmail.com
Received: June 23, 2025 Revised: July 8, 2025 Accepted: October 10, 2025 Published online: December 9, 2025 Processing time: 160 Days and 3 Hours
Abstract
Ivabradine, a selective inhibitor of the funny current in the sinoatrial node, has emerged as a promising agent for heart rate modulation in acute and critical care settings. Unlike beta-blockers, ivabradine reduces heart rate without affecting myocardial contractility, making it a valuable option for patients contraindicated for traditional therapies. This review examines its mechanism of action, clinical applications, comparative efficacy, and safety profile. It incorporates recent literature to assess its expanding role in managing acute coronary syndrome, acute decompensated heart failure, and sepsis-induced tachycardia.
Core Tip: Ivabradine reduces heart rate by specifically inhibiting the funny current in the sinoatrial node, without impacting myocardial contractility or blood pressure. This distinctive characteristic renders it an appealing choice for critically sick patients for whom beta-blockers are contraindicated or poorly tolerated. Recent studies corroborate its significance in acute scenarios, including acute decompensated heart failure, acute coronary syndrome, and sepsis-induced tachycardia, where a higher heart rate exacerbates outcomes. This review looks at the mechanism of action, clinical uses, comparative effectiveness, and safety profile.
