Heart failure medication may offer relief for patients with COVID-related POTS

Ivabradine, a common heart failure medication, could be used to treat symptoms associated with postural orthostatic tachycardia syndrome (POTS), according to a new study published in the Journal of the American College of Cardiology.

POTS is typically related to a viral infection or trauma, the authors observed, but it has more recently been identified in COVID-19 patients.

For this analysis, researchers evaluated 22 patients with hyperadrenergic POTS who were treated with either ivabradine or a placebo for one month. Each participant was then crossed over to the other treatment option for an additional month. The average patient age was approximately 34 years old, and 95.5% of patients were women.

Overall, the team found that ivabradine was a “safe and effective” POTS treatment associated with making significant improvements to patient heart rates and quality of life.

“Ivabradine is a novel agent that’s FDA-approved for heart failure, but based on its mechanism we thought it could be helpful for patients with POTS as it reduces heart rate without impacting blood pressure,” lead author Pam Taub, MD, a cardiologist at the Cardiovascular Institute at UC San Diego Health and associate professor at UC San Diego School of Medicine, said in a prepared statement. “When we can lower the heart rate, we’re providing these patients with the ability to stand up, something they couldn’t do without difficulty before due to their POTS diagnosis.”

“In our contemporary practice, we are seeing patients who have previously been infected with COVID-19 present with symptoms consistent with POTS,” added co-author Jonathan Hsu, MD, a cardiologist at UC San Diego Health. “Given the similarities, this study leads to the question whether therapy with ivabradine may help patients who experience similar symptoms after a COVID-19 infection, and provide an important area for future study as well.”

The full study is available here.