Ivabradine for Inappropriate Sinus Tachycardia?

[rxcst142]

Hi Everyone,

Looking to see if anyone has been diagnosed with Inappropriate Sinus Tachycardia and if they've tried Ivabradine with any success? I've been appealing to my health insurance company and two foundations since the cost would be roughly $400, but so far no luck since the appeals began in October of 2018. I'm trying to see if it's worth continuing the appeal process since my syncopal episodes have been getting worse and even on a 'good' day I feel exhausted. Since Ivabradine isn't guaranteed to work I was just curious if anyone has found it helpful with IST symptom management.

Thanks!

[KRG13]

I was put on Ivabradine for IST.. but eventually my diagnosis was changed to SNRT.. the ivabradine was making me feel terrible.. hypotension and bradycardia were unbearable. Had to stop. After the diagnosis changed, propafenone really worked

[rxcst142 in reply to KRG13]

Thank you so much! It was a challenge to even get a confirmed diagnosis of IST in the first place and sometimes it's still a struggle when ER docs assume it's just anxiety. It's hard to believe I felt great after my SVT ablation and now it's like being back at square one with the syncope and rapid heart rate. At this point I'd give just about anything a try to help alleviate symptoms and it doesn't seem like the insurance company is going to budge anytime soon.

[2k2d]

Hi rxcst142,

Sorry to hear you are dealing with that. I too have been “sort of” diagnosed with IST and possibly SNRT. I say sort of because honestly when you have weird stuff going on, doctors are more in the “we think you have...” mindset.

I have tried ivabradine too and it worked but made me feel pretty funky, like my heart was being constricted. But, I would have had no problem staying on it since I felt way worse on nothing, but it’s too expensive. My doctor gave me enough free samples to try it for about 3 mos. Maybe yours is willing? Better to see if it works and you can tolerate it before you go to all that trouble. Plus, how you react to it can give drs a further clue on what “it” is that you have or they think you have 😉.

And just so you know what worked for me is a very small dosage (12.5mg) of metoprolol a few times per day depending on my level of excitement, exercise, etc. Yes, my BP and pulse can get low on that sometimes but I’ve never passed out, I just counter with coffee and exercise. My life now is a day to day balance that works out well most days.

Good luck and keep us posted on what you end up doing!

[rxcst142 in reply to 2k2d]

Thank you so much for the info 2k2d! I was quoted roughly $432 a month since insurance doesn't cover Ivabradine for IST and even if the insurance company reverses their previous denials it would be a little over $300 per month or down to $200 for mail order. The whole process has been quite a challenge. I'm glad to hear it worked for you, but that you also found other ways to strike a balance that works the majority of the time! I've been trying to find other doctors that have successfully prescribed Ivabradine, but in the region where I live it seems as though patients either dish out the money or go without, which is why I'm half tempted to trial it for a month out-of-pocket to see if it helps.