Role of Ivabradine for Heart Rate Control in Management of Patients With Sepsis and Septic Shock

Inclusion Criteria: * Patients with proven or suspected site of infection. * Patients sepsis (acute organ dysfunction secondary to documented or suspected infection) * Patients with septic shock (defined as hypotension unresponsive to fluid resuscitation and requiring vasopressor treatment to maintain adequate blood pressure) for at least 6 hours and less than 24 hours. * Patients with sinus rhythm with heart rate ≥ 95 bpm at time of randomization. Informed consent obtained in accordance with local regulations. Exclusion Criteria: * Cardiac arrhythmia, conduction disorder, sinus syndrome ("sick sinus syndrome"), atrial fibrillation and heart block. * Cardiogenic shock or acute heart failure, without proven or suspected infection. * Acute coronary syndrome. * Refractory shock with systolic arterial pressure \<90 mm Hg despite the use of high doses of vasopressors. * Co-treatment with drugs inducing bradycardia. * Patients with pacemakers. * Known pregnancy, breast-feeding, women with of childbearing potential will be tested for pregnancy and excluded if pregnant. * Known allergy to Ivabradine * Severe renal failure (creatinine clearance \<15 ml/min) or hepatic failure (prothrombin time \<20%) * Tachycardia due to hyperthyroidism, pheochromocytoma or severe anemia (\<7 g/dl) * Enteral feeding impossible.