【Abstract】 Objective To investigate the effect of ivabradine on cardiac function and plasma N-terminal brain natriuretic peptide in elderly patients with heart failure and asthenia syndrome. Methods Ninetysix elderly patients with heart failure and wasting syndrome treated from January 2018 to December 2019 were selected as the research subjects. The random number table was divided into the control group (n=48) and the observation group (n=48). The control group was given conventional drug treatment, and the observation group was combined with ivabradine treatment on the basis of the control group. The cardiac function indexes, hs-CRP, NT-proBNP levels, ADL score, SAS score, and sixminute walking distance were compared between the two groups of patients before and after treatment. Results There was no statistically significant difference in cardiac function indexes between the two groups of patients before treatment (P＞0.05). The cardiac function indexes of the two groups were improved after treatment. The LVEDD and LVESD indexes of the observation group were lower than those of the control group. The CO and CI indicators were higher than those in the control group (P＜0.05). hs-CRP and NT-proBNP levels were not statistically significant before treatment in the two groups (P＞0.05). hs-CRP and NT-proBNP were observed in the observation group after treatment. Levels were lower than those in the control group (P＜0.05). ADL scores and sixminute walking distances after treatment were higher in both groups than before treatment (P＜0.05). SAS scores were lower than before treatment (P＜0.05). After treatment in the observation group ADL score and sixminute walking distance were higher than the control group (P＜0.05), and SAS score was lower than the control group (P＜0.05). Conclusion Ivabradine is effective in treating elderly patients with heart failure and wasting syndrome. It can effectively improve the heart function of patients, reduce the levels of hs-CRP and NT-proBNP in plasma, and improve the prognosis of patients.