key: cord-0013271-f1zb5zgm
authors: Fontenla, Adolfo; Tamargo Menéndez, Juan; López Gil, María; Arribas, Fernando
title: Do we have a new drug for heart rate control in patients with permanent atrial fibrillation? Response
date: 2020-10-14
journal: Rev Esp Cardiol (Engl Ed)
DOI: 10.1016/j.rec.2020.08.016
sha: 67f478a48b3974b3450420de3b46666a341fa605
doc_id: 13271
cord_uid: f1zb5zgm

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Do we have a new drug for heart rate control in patients with permanent atrial fibrillation? Response ? Hay un nuevo fármaco disponible para el control de la frecuencia cardiaca de pacientes con fibrilación auricular permanente? Respuesta

To the Editor,

We thank Drs Rivas-Gá ndara and Francisco-Pascual for their interest shown in the BRAKE-AF project. 1 There is indeed evidence to suggest that ivabradine could be effective for rate control in permanent atrial fibrillation (AF). Following publication of its efficacy in a patient with poorlycontrolled AF, 2 we were aware that to ''make this hypothesis a reality'' we would need to conduct a clinical trial. 3 Permanent AF is the most common form of AF yet, surprisingly, new drugs for rate control have not been developed in the past 30 years. The industrial development of antiarrhythmic drugs is increasingly uncommon, probably because it involves investment that is risky and/or with small profit margins; this means that clinicians must assess the antiarrhythmic effect of drugs that are marketed for other indications, as is the case with ranolazine. 4 We would like to point out that the BRAKE-AF project was undertaken with public funding only and thanks to the generous effort of independent investigators: cardiologists from several hospitals and pharmacologists from the Universidad Complutense de Madrid.

Our trial is currently in the recruitment phase, and bears the difficulties inherent to any clinical trial with the added impact of the recent COVID-19 outbreak. Like Rivas-Gá ndara and other authers, 5 we hope that the BRAKE-AF trial will answer the question of whether there is a new drug for rate control in AF. If so, the next question will be, ''Could ivabradine improve prognosis in patients with permanent AF?'' 

Ivabradine for chronic heart rate control in persistent atrial fibrillation. Design of the BRAKE-AF project

Ivabradine as an alternative to AV node ablation in a patient with permanent atrial fibrillation

Ló pez-Gil M. Ivabradine as an atrioventricular node modulator. Promise or reality? Response

Ranolazine in the treatment of atrial fibrillation: Results of the dose-ranging RAFFAELLO (Ranolazine in Atrial Fibrillation Following An ELectricaL CardiOversion) study

Ivabradine and AF: Coincidence, Correlation or a New Treatment?

Do we have a new drug for heart rate control in patients with permanent atrial fibrillation? Response