Copyright
©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Crit Care Med. Dec 9, 2025; 14(4): 111054
Published online Dec 9, 2025. doi: 10.5492/wjccm.v14.i4.111054
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, 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
Revised: July 8, 2025
Accepted: October 10, 2025
Published online: December 9, 2025
Processing time: 160 Days and 3 Hours
Core Tip
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 exacer