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[Selective and specific reduction in the heart rate: a promising direction in the creation of new cardiovascular drugs].

Numerous data indicate that a high heart rater (HR) is a risk factor in various cardiovascular diseases. The effects of HR on the energetics of myocardium, contractility function, collateral coronary blood circulation, and atherogenesis are considered. A special attention is devoted to specific bradycardic drugs and their mechanisms of action on the electrophysiological processes in the sinus node and on the HR. The new drug ivabradin (a specific selective blocker of the If current) can produce a bradycardic effect and exhibit a pronounced antiischemic action on the myocardium. The creation of such drugs offers an alternative to beta-adrenoblockers and calcium antagonists and opens new possibilities in the pharmacological protection of ischemized myocardium.