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ME/CFS Science @mecfsscience.org · 17/05/2026

1) A randomized crossover trial found that both ivabradine and the beta-blocker propranolol were effective at lowering heart rate in patients with POTS. There wasn't a clear effect, though, on symptoms or functional capacity.

Screenshot of the study "A Randomized Crossover Trial of Ivabradine, Propranolol, and Placebo in Postural Orthostatic Tachycardia Syndrome"

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ME/CFS Science @mecfsscience.org · 17/05/2026

2) The study was a crossover trial, meaning all participants got the 3 treatments: ivabradine (5 mg), propranolol (4 x 10 mg), or placebo in consecutive order with a 7-day washout period in between. Each treatment period lasted 28 days.

Study design flowchart for the randomized crossover drug trial of ivabradine, propranolol, and placebo in POTS. Each phase is broken down into 28 + 7 days with a 7-day washout period between phases.

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ME/CFS Science @mecfsscience.org · 17/05/2026

3) Ivabradine got slightly better results, so let's zoom in on its comparison to the placebo. The graph below shows a very notable effect on heart rate during a 10-minute head-up tilt test. The mean heart rate was also 15 bpm lower in 24-hour Holter monitor recordings.

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