IRCT20241212064032N1 IRCT 2025-01-08 Pervaiz Ilahi Institute of Cardiology, QAMC, BVH, Bahawalpur Comparison of Effectiveness between Ivabradine and Beta Blockers in Patients of Permanent Atrial Fibrillation Comparative Efficacy of Ivabradine Versus Beta Blockers in Treatment of Uncontrolled Permanent Atrial Fibrillation 2025-02-01 anticipated 60 Complete https://irct.ir/trial/80782 interventional Randomization: Randomized, Blinding: Single blinded, Placebo: Not used, Assignment: Parallel, Purpose: Treatment, Randomization description: Non probability purposive sampling technique will be employed and adaptive randomization will be done according to the set criteria, Blinding description: Participants are blinded in this study as they won't know which drug group they are assigned. 3 Chronic (permanent) Atrial Fibrillation. Intervention 1: Intervention Group 1; This group will consist of 30 patients of permanent uncontrolled atrial fibrillation, fulfilling inclusion criteria and intolerant to beta blockers (patients having asthma, COPD, hypotension, peripheral arterial diseases, diabetics who are prone to hypoglycemia or allergic to beta blockers). After informed consent, prospectively designed data collection Performa will be used to collect baseline information including history and demographic details. All patients will be subjected to ECG, and comprehensive clinical evaluation will be done including all baseline investigations i.e hemoglobin, serum creatinine, eGFR, transthoracic echo TTE. Systolic and diastolic BP readings and resting heart rate will be noted by duty doctor. This group will then be commenced on per oral drug IVABRADINE. A dosage of 5 milligrams per oral every 12 hours will be given for one month. Subsequently if patient tolerates this dose it can be increased to maintenance dose of 7.5 milligrams every 12 hours. Patients who are 75 years old or more will be started on 2.5 mg 12 hourly and if tolerated well the dose can increased up to 5mg 12 hourly. Two follow up visits will be planned, one after 2 weeks and second after one month since the commencement of intervention (treatment). At each visit resting heart rate (15 minutes after sitting comfortably), systolic and diastolic BP will be noted. History regarding syncope, palpitations, allergic reaction, treatment discontinuation or any adverse event will be noted on data collection Performa. Intervention 2: Intervention Group 2; This group also consists of 30 patients with uncontrolled permanent atrial fibrillation. Patients will be assigned this group after excluding any contraindication to beta blockers. After informed consent, history and basic demographic details will be noted on data collection Performa. Baseline resting heart rate ,systolic and diastolic BP will be noted. All baseline investigations will be done including ECG, hemoglobin, serum creatinine, Transthoracic echo TTE and eGFR. This group will be commenced on TABLET METOPROLOL 25 milligrams per oral 12 hourly. Subsequently the dose can be increased to therapeutic range of 25-100mg/12 hours depending upon the patient's response in following visits. Just like intervention group 1, two more follow up visits will be planned and at each visit resting heart rate, blood pressure and history regarding secondary endpoints will be noted on data collection Performa. No - There is not a plan to make this available Justification or reason for not sharing IPD is This topic is not yet discussed with the supervisor. I plan to share my data after research work is successful.