Ivabradine in controlling tachycardia among critically ill patients

This will be a prospective, double blind randomized, cross-over, study to evaluate the ability of Ivabradine to reduce an elevated heart rate in critically ill patients admitted in MICU / MHDU with severe tachycardia. The primary outcome of this study is the proportion of patients with a reduction of heart rate by at least 20 beats per minute (bpm) within 1 day of observation. This trial will randomize 100 patients (men and women, aged above 18 years) admitted in MICU /MHDU with sinus tachycardia (sinus rhythm with HR above 140 bpm). Subjects will be randomized based on computer generated programme to either Ivabradine or placebo group. Subjects in Ivabradine group will receive 2 doses of Ivabradine 7.5 mgs oral/NG at 12 hours apart. Subjects in the placebo group will receive 2 doses of Pantocid 40 mg via NG / oral at 12 hour apart. The period of observation will be 24 hours during which the HR and hemodynamic outcomes will be recorded once in 2 hours. After 12 hours of wash out period the subjects will cross over to second treatment period wherein the participants who received the Ivabradine will be given placebo and those who received placebo will receive Ivabradine. The outcome of interest will again be recorded 2 hourly for 24 hours. In addition any sudden events occurring in rate, rhythm or blood pressure will be noted during the period of the study.