In conclusion, ivabradine is an important therapeutic option for patients with HFrEF and elevated heart rate, particularly when β-blockers are ineffective or contraindicated. Supported by clinical trials like the SHIFT study and endorsed by major guidelines such as the ESC and ACC/AHA/HFSA, ivabradine has demonstrated efficacy in reducing heart failure hospitalizations and cardiovascular death. Proper patient selection and dosing are essential to maximize its therapeutic benefits.