American College of Cardiology Congress 2026 – Dr Pam Taub (University of California San Diego, La Jolla, US) joins us to discuss results from the RECOVER-Autonomic platform trial (NCT06305806; Kanecia Obie Zimmerman), evaluating the impact of ivabradine on orthostatic intolerance, quality of life, and heart rate in post-COVID POTS.

This randomised, placebo-controlled appendix trial enrolled 181 participants with confirmed prior SARS-CoV-2 infection and persistent autonomic dysfunction symptoms lasting at least 12 weeks. Participants were randomised to ivabradine or placebo over a 12-week treatment period, with an additional 3-month follow up. Alongside pharmacologic therapy, a coordinated non-pharmacologic care package, including dietary mediated volume expansion, exercise rehabilitation and patient education, was implemented. The platform design also allowed simultaneous assessment of IVIG in a parallel appendix, reflecting the hypothesis that immune-mediated mechanisms underlie autonomic dysfunction in post-acute sequelae of SARS-CoV-2 infection.

Findings showed that treatment with ivabradine alone did not significantly improve patient-reported orthostatic intolerance in patients with long COVID POTS. Researchers observed a significant reduction in heart rate change (supine to standing) compared to placebo.

Interview Questions:

1. How has our understanding of the underlying mechanisms of POST-COVID POTS evolved, and why was ivabradine selected as a priority intervention?
2. Can you walk us through the RECOVER-Autonomic platform design and what distinguished the ivabradine appendix in terms of patient selection and trial structure?
3. What were the key findings?
4. The trial also tested coordinated non-pharmacologic care alongside ivabradine — what role did this play, and does combining pharmacologic and lifestyle-based strategies offer additive benefit?
5. What are your key take-home messages for clinicians managing patients with long-COVID cardiovascular symptoms, and what research priorities should the field pursue next?

Recorded on-site at ACC 2026, New Orleans.

For more expert insights and late-breaking science from ACC 2026, visit the Late-breaking Science Video Collection.

Editor: Jordan Rance
Videographer: Dan Brent, David Ben-Harosh

Support: This is an independent interview produced by Radcliffe Cardiology.