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Case report
The use of ivabradine in a patient with inappropriate sinus tachycardia and cardiomyopathy due to limb girdle muscular dystrophy type 2I
  1. Rajkumar Rajendram1,2,
  2. Fahad AlDhahri3,4,
  3. Naveed Mahmood2,5 and
  4. Mubashar Kharal2,5
  1. 1Department of Anaesthesia and Intensive Care, Stoke Mandeville Hospital, Aylesbury, Buckinghamshire, UK
  2. 2College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
  3. 3Department of Pharmacy, King Abdulaziz Medical City, Riyadh, Al Riyadh Province, Saudi Arabia
  4. 4College of Pharmacy, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
  5. 5Department of Medicine, King Abdulaziz Medical City, Riyadh, Al Riyadh Province, Saudi Arabia
  1. Correspondence to Dr Rajkumar Rajendram; rajkumar.rajendram{at}nhs.net

Abstract

Muscular dystrophies are a heterogeneous group of disorders that commonly involve cardiac and skeletal muscle. Comprehensive guidelines for the management of cardiac failure and arrhythmias are available. However, the studies from which their recommendations are derived did not include any patients with muscular dystrophy. Some medications (eg, betablockers) may have significant side effects in this cohort. In some situations the use of agents with unique mechanisms of action such as ivabradine (a ‘funny’ channel inhibitor) may be more appropriate. Use of ivabradine has not previously been reported in limb girdle muscular dystrophy (LGMD). We describe the course of a patient with LGMD type 2I, cardiomyopathy and inappropriate sinus tachycardia treated with ivabradine. As advances in respiratory support have improved the outcomes of patients with muscular dystrophy; the prognostic significance of cardiac disease has increased. Ivabradine is tolerated and may reduce symptoms, morbidity and mortality in this cohort.

  • arrhythmias
  • heart failure
  • neuromuscular disease
  • cardiovascular system
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Footnotes

  • Contributors RR and FAD were involved with conceptualisation, data collection, preparation of the manuscript, editing and approval of the final manuscript for publication. NM and MK were involved with preparation of the manuscript, editing and approval of the final manuscript for publication.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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