
Do Cardivas And Ivabrad Affect The Heart Rate?

I sincerely request you to look into this case and answer my query .
Medical history : hypertension from past 9 years and acidity problem
Age : 60 years
Sex : Male
My Father got an acute MI on 16th November, prior to this from past 10 days he was suffering from low blood pressure and our family doc asked him to stop the BP tablet for few days . on 16th nov since morning 5 am he got high acidity and chest pain but we thought it was acidity we gave rantac and other home remedies but he started sweating and got severe pain in the chest. We took him to the nearby hospital and the doctor immediately did the angiography and found the main coronary artery was 100% blocked which had to be stented immediately but he said its very risky as you have reached late the damage has already happened. He processed with the angioplasty there were total 3 blockages on the left side 2 were done via balloon and the 100% blockage one was stented .
Post the surgery on the next day my dad started feeling high acidity , big burps , heaviness in the chest and his heart rate was very high. From then we were in the hospital till 25th Nov till his heart rate and BP and other things got normal. He had little breathlessness also.
Post returning home on 25th , my dad felt very weak at home and again on 2nd dec we got readmitted for Low blood pressure as my dad fainted at home and we checked the bp was very low and hence we got him to the hospital . Doctors admitted him to the ICCU and started giving fluids to bring up his BP
Doctors said , low BP was due to dehydration as my father had gone for motions thrice that particular morning and since the intake of fluids is restricted to 1.5 ltrs XXXXXXX
Previous medication when we got discharged on 25th Nov : Cardivas, Ivabrad, ecosprin, brillinta, restyl for sleep and now since my dad complained of breathlessness they have changed the medication and now they have discontinued cardivas completely and increased the dose of ivabrad and asked to stop brillinta and take prax 10mg
Currently My dad went for a follow up session with the doc , he asked him to stop ivabrad and start taking cardivas tablet, I would like to know the reason for the same and what is the difference between the two tablets Ivabrad and cardivas ? please suggest
Please advice .
Both medicines have different action
Detailed Answer:
Hi,
I would first like to answer the question you have asked.
Cardivas and ivabrad both reduces heart rate, the difference is that ivabrad does not effect bp whereas cardivas decrease the bp.
So for a patient with high heart rate and low bp, we prefer ivabrad.
But cardivas is an important medicine as it improves heart function and prevents a further heart attack. So as soon as the bp normalize, your doctor will want to continue it back.
It would be better if you could tell me the echo report of his to know the percentage of functioning heart (LVEF) and the current bp range he has been having.
As he is currently dehydrated, some medicine will be started at a later time when he is stable and bp is fine, these include - ACE inhibitor (Ramistar/Cardace), Diuretic (Lasix or dytor) and Eptus. These all are very important for a weak heart.
Hope I have answered your query. Let me know if I can assist you further.
Take care
Regards,
Dr Sameer Maheshwari, Cardiologist


Thanks for the advice. He current blood pressure is 100/70 and pulse rate is 59 or 60 XXXXXXX 63 or 65 at times.
Also his current medications are
Dytor plus
Prax 10mg
Ecosprin 75
Atorva 80
Ivabrad 5mg
Supradin
Now as I told you doc has asked to stop ivabrad and start cardivas . I am attaccing his current echo and ecg report pls advice y the doc has changed medication from
Ivabrad to cardivas will cardivas increase the pulse rate but again that is not good right?
Pls advice
Cardivas will reduce the heart rate
Detailed Answer:
Hi,
I went through the reports you have attached. He has low heart function, around 35%, the normal being above 55%.
This is because of the heart attack for which he has already got a stent.
As I told you in my earlier answer that both ivabrad and cardivas reduces the heart rate. Ivabrad does not have any effect on bp and is preferred when bp is too low.
Cardivas is important for the heart and prevents future heart attacks and improve heart function. So cardivas is a better drug and will reduce the heart rate not increase it.
The other medications he is getting are good and i expect the addition of another medicine (Ramipril) once his bp increases further.
Hope I have answered your query.
Take care
Regards,
Dr Sameer Maheshwari, Cardiologist

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