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Murdock DK, Overton N, Kersten M, et al. The effect of ranolazine on maintaining sinus rhythm in patients with resistant atrial fibrillation. Indian Pacing Electrophysiol J. 2008;8(3):175-81
Murdock, D. K., Overton, N., Kersten, M., Kaliebe, J., & Devecchi, F. (2008). The effect of ranolazine on maintaining sinus rhythm in patients with resistant atrial fibrillation. Indian pacing and electrophysiology journal, 8(3), 175-81.
Murdock, David K, et al. "The effect of ranolazine on maintaining sinus rhythm in patients with resistant atrial fibrillation." Indian pacing and electrophysiology journal vol. 8,3 (2008): 175-81.
Murdock DK, Overton N, Kersten M, Kaliebe J, Devecchi F. The effect of ranolazine on maintaining sinus rhythm in patients with resistant atrial fibrillation. Indian Pacing Electrophysiol J. 2008 Aug 01;8(3):175-81. PMID: 18679523; PMCID: PMC2490806.
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Indian Pacing Electrophysiol J. 2008 Aug 01;8(3):175-81.

The effect of ranolazine on maintaining sinus rhythm in patients with resistant atrial fibrillation.

Indian pacing and electrophysiology journal

David K Murdock, Naomi Overton, Mary Kersten, Jeff Kaliebe, Fausto Devecchi

Affiliations

  1. Cardiovascular Associates of Northern Wisconsin, S.C., CaRE Foundation, Inc., USA. [email protected]

PMID: 18679523 PMCID: PMC2490806

Abstract

BACKGROUND: Atrial fibrillation (AF) may arise out of anomalous impulse activity at atrial venous junctions. Triggered activity may be a source of abnormal impulse activity. Ranolazine is an anti-anginal agent, which inhibits normal and abnormal late Na+ channel current in the ventricle and peak Na+ channel current in the atrium. This produces an energy sparing effect and stabilizes cardiac membranes. Ranolazine is a potent inhibitor of triggered activity. The purpose of this report is to describe our initial experience with ranolazine used in patients with resistant AF.

METHODS: Seven patients (4 males, 3 females, 67 +/- 9 years) who developed recurrent AF within hours to a few days of restoring sinus rhythm despite AF ablation and /or failing one or more anti-arrhythmic agents were started on ranolazine (500-1000 mg/twice/day) after stopping all other anti-arrhythmic therapy. All but one patient had some form of associated structural heart disease.

RESULTS: Two patients received no apparent benefit from ranolazine developing recurrent AF within 2 days. All other patients derived significant benefit. Four patients have experienced no recurrent AF. The other patient relapsed at 3 months and again at 6 months. The mean time in sinus rhythm to date, or to the first relapse, for the five responders was 27 +/- 11 weeks. No clinically evident pro-arrhythmic episodes occurred.

CONCLUSION: Ranolazine was helpful in maintaining sinus rhythm in the majority of patients in which more established measures had failed. A controlled prospective trial is warranted to further investigate the efficacy of ranolazine in AF.

Keywords: atrial fibrillation; cardiac arrhythmias; ranolazine

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