NICE recommends ivabradine as a possible treatment for some people with chronic heart failure (see below).
Who can have ivabradine?
You should be able to have ivabradine if all of the following apply:
- You have symptoms of heart failure and your heart isn’t contracting properly, but your condition is stable.
- You have a regular heartbeat of 75 beats per minute or more.
- You are given ivabradine alongside standard drugs for heart failure, or instead of beta-blockers if you cannot take them.
- Your left ventricular ejection fraction or LVEF for short (the amount of blood pumped out by the left side of your heart) is below 35%.
If you are eligible for ivabradine as above, before starting ivabradine you should first have 4 weeks of treatment with standard drugs for heart failure to see if the right combination and dose of standard drugs alone can treat your symptoms.
Treatment with ivabradine should be started by a specialist. But after that either a GP with a special interest in heart failure or a heart failure specialist nurse can adjust your dose and monitor your condition.
Why has NICE said this?
NICE looks at how well treatments work, and also at how well they work in relation to how much they cost the NHS.
NICE recommended ivabradine because when it is combined with standard treatment, the benefit to patients justifies the extra cost.
The recommendations in this guidance represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, health professionals are expected to take this guidance fully into account, alongside the individual needs, preferences and values of their patients. The application of the recommendations in this guidance is at the discretion of health professionals and their individual patients and do not override the responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or their carer or guardian.
Commissioners and/or providers have a responsibility to provide the funding required to enable the guidance to be applied when individual health professionals and their patients wish to use it, in accordance with the NHS Constitution. They should do so in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities.