The 2016 ACC/AHA/HFSA Guideline Update includes Corlanor® as a recommended treatment option for HF1

The 2016 ACC/AHA/HFSA Focused Update on New Pharmacological Therapy for Heart Failure:
An Update of the 2013 ACCF/AHA Guideline for the Management of Heart Failure includes Corlanor® (ivabradine) as a recommended treatment option for HF1

Recommendation for Ivabradine

Ivabradine can be beneficial to reduce HF hospitalization for patients with symptomatic (NYHA Class II-III) stable chronic HFrEF (LVEF 35%) who are receiving Guideline Directed Evaluation and Management, including a beta- blocker at maximum-tolerated dose, and who are in sinus rhythm with a heart rate of 70 bpm or greater at rest.

*Class IIa (moderate) is defined as useful, effective, or beneficial, and the benefit is greater than the risk.
Level B-R is defined as moderate-quality evidence from 1 or more randomized control trials.

COR = Class of Recommendation; LOE = Level of Evidence.


1. Yancy CW, Jessup M, Bozkurt B, et al. Circulation. 2016;134. doi: 10.1161/CIR.0000000000000435.


IMPORTANT SAFETY INFORMATION Contraindications: Corlanor® is contraindicated in patients with acute decompensated heart failure, blood pressure < 90/50 mmHg, sick sinus syndrome, sinoatrial block, 3rd degree atrioventricular block (unless a functioning demand pacemaker is present), a resting heart rate < 60 bpm prior to treatment, severe hepatic impairment, pacemaker dependence (heart rate maintained exclusively by the pacemaker), and concomitant use of strong cytochrome P450 3A4 (CYP3A4) inhibitors.

Fetal Toxicity: Corlanor® may cause fetal toxicity when administered to a pregnant woman based on embryo-fetal toxicity and cardiac teratogenic effects observed in animal studies. Advise females to use effective contraception when taking Corlanor®.

Atrial Fibrillation: Corlanor® increases the risk of atrial fibrillation. The rate of atrial fibrillation in patients treated with Corlanor® compared to placebo was 5% vs. 3.9% per patient-year, respectively. Regularly monitor cardiac rhythm. Discontinue Corlanor® if atrial fibrillation develops.

Bradycardia and Conduction Disturbances: Bradycardia, sinus arrest and heart block have occurred with Corlanor®. The rate of bradycardia in patients treated with Corlanor® compared to placebo was 6% (2.7% symptomatic; 3.4% asymptomatic) vs. 1.3% per patient‐year, respectively. Risk factors for bradycardia include sinus node dysfunction, conduction defects, ventricular dyssynchrony, and use of other negative chronotropes. Bradycardia may increase the risk of QT prolongation which may lead to severe ventricular arrhythmias, including torsades de pointes, especially in patients with risk factors such as use of QTc prolonging drugs.

Concurrent use of verapamil or diltiazem also increases Corlanor® exposure, contributes to heart rate lowering, and should be avoided. Avoid use of Corlanor® in patients with 2nd degree atrioventricular block unless a functioning demand pacemaker is present

Adverse Reactions: The most common adverse drug reactions reported at least 1% more frequently with Corlanor® than placebo and that occurred in more than 1% of patients treated with Corlanor® were bradycardia (10% vs. 2.2%), hypertension or increased blood pressure (8.9% vs. 7.8%), atrial fibrillation (8.3% vs. 6.6%), and luminous phenomena (phosphenes) or visual brightness (2.8% vs. 0.5%).

In postmarketing experience, torsades de pointes has been observed.


Corlanor® (ivabradine) is indicated to reduce the risk of hospitalization for worsening heart failure in patients with stable, symptomatic chronic heart failure with left ventricular ejection fraction 35%, who are in sinus rhythm with resting heart rate 70 beats per minute and either are on maximally tolerated doses of beta-blockers or have a contraindication to beta-blocker use.

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