Effect of short-term targeted heart rate control with Ivabradine versus Esmolol in septic shock with refractory tachycardia: A randomised controlled trial

Sepsis accounts for high mortality in Intensive care unit. Hemodynamic alterations which occur as compensatory mechanism such as Tachycardia increases the mortality in sepsis. Therefore, heart rate control in sepsis improves the myocardial function by increasing diastolic filling time. Beta 1 receptor blockers such as Esmolol have been used in multiple studies to achieve heart rate control and use is associated with reduced vasopressor requirements and cardiac performance.

Another pharamacological agent Ivabradine has been investigated recently in couple of trials which have shown favourable heart rate control, reduced vasopressor requirements, improved macro and microcirculatory parameters in sepsis.

These two agents i.e Esmolol and Ivabradine have never been compared head to head. This study aims to compare the two agents in terms of safety and efficacy hypothesising that Ivabradine is non inferior to Esmolol.