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Comparison of ivabradine, atenolol, and metoprolol for heart rate control in patients with ischemic heart disease before cardiac CT examination

Verified siteRegistered drugNo placebo
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What is this trial about?

A plain-language summary of the goals, design and what participants do

This clinical trial focuses on patients with ischemic heart disease who need to undergo a cardiac CT scan. The study compares different medications used to control heart rate before the imaging procedure. The medications being tested include ivabradine and two types of beta-blockers: atenolol combined with chlortalidone, and metoprolol succinate.

The purpose of this research is to find out which medication works fastest to lower heart rate in patients whose resting heart rate is above 65 beats per minute. The medications will be given by mouth, with different maximum daily doses: ivabradine up to 15 mg, atenolol up to 100 mg, and metoprolol succinate up to 200 mg.

During the study, patients will receive one of these medications before their cardiac CT scan. The heart rate will be monitored to see how quickly it decreases after taking the medication. A cardiac CT scan is a specialized X-ray examination that provides detailed images of the heart and blood vessels.

The research process

The trial runs in 5 steps – from screening to follow-up. Each step says what happens and what the team monitors.

  1. Step 1

    Initial heart rate measurement

    Your heart rate will be measured using an ECG (electrocardiogram) to confirm it is above 65 beats per minute

    This measurement will serve as your baseline heart rate for the study

  2. Step 2

    Medication assignment

    You will receive one of the following medications taken by mouth:

    - Ivabradine (a heart rate lowering medication)

    - Atenolol with chlortalidone (a beta-blocker medication)

    - Metoprolol (a beta-blocker medication)

  3. Step 3

    Heart rate monitoring

    Your heart rate will be monitored to track when it decreases by 10% from your starting heart rate

    The time it takes to reach this decrease will be recorded

  4. Step 4

    Cardiac CT preparation

    Once your heart rate has reached the target level, you will be prepared for your scheduled cardiac CT (computed tomography) scan

    This imaging test will examine your heart for signs of reduced blood flow

  5. Step 5

    Completion of cardiac CT

    The cardiac CT scan will be performed to evaluate your heart condition

    This concludes your participation in the study procedures

Who can join the trial?

6 criteria

  • You must be scheduled for a cardiac CT scan (a special X-ray examination of your heart)
  • You must have a normal heart rhythm (called sinus rhythm) with a heart rate faster than 65 beats per minute, confirmed by ECG (a test that records your heart's electrical activity)
  • You must be able to understand and sign an informed consent form
  • You must be an adult (18 years or older)
  • You can be either male or female
  • You must not be part of a vulnerable population (such as prisoners or persons unable to give consent)

Who cannot join the trial?

15 criteria

  • Age below 18 years or above 65 years
  • Known allergies to beta-blockers (heart rate-lowering medications) or ivabradine
  • Heart rate below 65 beats per minute at rest
  • Severe kidney or liver disease
  • Pregnancy or breastfeeding
  • Current participation in other clinical trials
  • Uncontrolled high blood pressure (hypertension)
  • History of severe heart rhythm disorders
  • Recent heart attack (within last 3 months)
  • Severe breathing problems or asthma
  • Taking medications that could interact with study drugs
  • Unable to give informed consent
  • History of severe depression or mental illness
  • Severe allergic reactions to medical contrast agents used in CT scans
  • Inability to follow study procedures or attend scheduled visits
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Investigated drugs

  • Beta-blockers

    are medications that help slow down your heart rate and lower blood pressure. They work by blocking the effects of certain hormones like adrenaline on your heart. These medications are commonly used before cardiac CT scans to help create clearer images of the heart by reducing its movement.

  • Ivabradine

    is a medication that specifically slows down heart rate without affecting blood pressure. It works differently from beta-blockers by targeting specific channels in the heart that control its rhythm. This medication can be particularly useful for patients who need their heart rate lowered but cannot take or tolerate beta-blockers.

What is already known about the treatment

  • Ivabradine

    A heart rate-lowering medication administered orally in tablet form, specifically designed to reduce heart rate in patients with stable angina and heart failure. This medication works by selectively inhibiting the If ("funny") channels in the heart's sinus node, which uniquely differentiates it from traditional beta-blockers in its mechanism of action. Ivabradine belongs to the class of medications known as sinus node inhibitors and is primarily used in treating chronic stable angina and heart failure, particularly in patients who cannot tolerate beta-blockers or when beta-blockers alone are insufficient.

  • Beta-blockers

    A class of medications typically taken orally that work by blocking the effects of adrenaline and similar hormones on the heart and blood vessels. These medications reduce heart rate and blood pressure by blocking beta-adrenergic receptors in the heart, making the heart beat more slowly and with less force. Beta-blockers are widely used in treating various cardiovascular conditions, including high blood pressure, heart failure, angina, and abnormal heart rhythms, and are particularly valuable in reducing cardiac workload during medical imaging procedures like CT scans.

Investigated diseases

Ischemic Heart Disease - A condition where the heart muscle doesn't get enough blood and oxygen due to narrowed or blocked coronary arteries. The arteries become narrowed over time due to the buildup of fatty deposits called plaque on their inner walls. This process, known as atherosclerosis, reduces blood flow to the heart muscle. The reduced blood flow can cause chest pain (angina) during physical activity or stress. The condition typically develops gradually over many years and can affect people of various ages. The heart has to work harder to pump blood through the narrowed vessels, which can lead to fatigue and shortness of breath.
Trial detailsLast updated 7 Oct 2026
Age18+ yearsPhasePhase IIITrial ID2025-522741-21-00Estimated enrolment350 patientsSponsorRegion Midtjylland

sourced from the EU Clinical Trials Register and site verification

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