Ivabradine in Cardiogenic Shock

Management of patients in cardiogenic shock (CS) relies on limited evidence. Hemodynamic targets, including heart rate, are empirical and vary between institutions. While some degree of tachycardia may be compensatory, excessive tachycardia can be detrimental. In CS, tachycardia is often exacerbated by vasopressors and inotropes. We hypothesize, that mitigating excessive tachycardia may result in prolonging diastole, improvement in diastolic filling, and enhancing subsequent cardiac contraction, thereby eliciting a hemodynamically favorable response.