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Ivabradine is a small molecule drug used primarily for the symptomatic management of chronic heart failure and stable angina pectoris. It acts as a selective inhibitor of the hyperpolarization-activated cyclic nucleotide-gated (HCN) channels—specifically targeting the "funny" current (If) in the sinoatrial node. By inhibiting these channels, ivabradine slows pacemaker activity and reduces heart rate without affecting myocardial contractility or blood pressure. This mechanism allows for improved oxygen supply to cardiac tissue and reduced risk of hospitalization due to worsening heart failure. Ivabradine is approved for use in adults with chronic heart failure with reduced ejection fraction and in children aged 6 months or older with dilated cardiomyopathy[1][3][4][5][6].
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