Objective To investigate the effect of early use of ivabradine on cardiac function in patients with acute myocardial infarction (AMI) after percutaneous coronary intervention (PCI). Methods Eighty patients with AMI who were hospitalized in our hospital from Feb. 2020 to May 2021 were enrolled, and were randomly assigned to ivabradine group or control group (1∶1). All patients were successfully treated with emergency PCI, and the ivabradine group was treated with ivabradine combined with metoprolol after PCI, while the control group was treated with metoprolol only. Both groups were followed up for 1 year. Echocardiography-derived parameters, heart rate and myocardial markers were analyzed. Results The left ventricular ejection fraction was significantly higher in the ivabradine group than in the control group at 1 week, 3 months, and 1 year after PCI (all P＜0.05). The heart rate of the ivabradine group was significantly lower than that of the control group at 1 week after PCI (P＜0.05), while there was no significant difference in heart rates between the 2 groups at 3 months or 1 year after PCI (both P＞0.05). The brain natriuretic peptide of the ivabradine group was significantly lower than that of the control group on day 2 and day 3 after PCI (both P＜0.05). The troponin I level of the ivabradine group was significantly lower than that of the control group on day 5 after PCI (P＜0.05). Conclusion Early use of ivabradine in patients with AMI after PCI can achieve effective heart rate control, reduce myocardial injury and improve cardiac function.