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Background Ranolazine is a piperazine derivative, mainly used as antianginal drug in patients with ischemic disease of the heart (IDH). Despite its antianginal effect, it has an antiarrhythmic effect by inhibiting of late sodium and rapid potassium rectifier current. Aim of the study was to assess the additional antiarrhythmic efficacy of ranolazine in patients with new onset atrial fibrillation (AF) and IDH. Material and Methods 168 eligible patients with IDH and short duration of new onset AF were enrolled in this study. Among them, 92 were treated additionally ranolazine to the standart therapy – Group I while 76 only with standart therapy – Group II. The choice of antiarrhythmic drug for cardioversion was either amiodarone or propafenone at the discretion of the doctor. Primary endpoint was recovering of sinus rhythm. All statistical analysis were performed using student t-test. Results Mean age of patients was 66 ± 11.5 years, male 48% in ranolazine group (Group I) and 64.5 ± 12.0 years, male 46% in Group II, and there were no statistically significant differences between two groups. Both groups of patients were characterized by median AF episode duration of 12 (4; 24) hours. Amiadoron was administered in 70 % (n = 65) of patients in Group I and in 77% (n = 59); propafenon in 30% (n = 17) of patients in Group I and 23% (n = 17) in Group II. Cardioversion rate was significantly higher in Group I than Group II (87% vs. 74%, P < 0.05;). There were not observed safety endpoints in Group I whereas 3 safety endpoints (severe bradycardia and arterial hypotension) were observed in Group II (P > 0.05). Conclusion Adding ranolazine to the standard therapy in patients with IDH seems to have a beneficial role in restoring sinus rhythm in recent new onset AF.

Background Ranolazine currently is used to relief angina symptoms in patients with chronic coronary syndrome (CCS). Additional its anti-angina effect it has been showing antiarrhythmic effect by predominantly inhibiting late sodium and rapid potassium rectifier current. We aimed to assess the efficacy of ranolazine for the prevention of atrial fibrillation (AF) in high-risk patients older than 60 years with CCS at least >5 years and hypertension. Methods 264 older high-risk patients (>60 years) with CCS and hypertension were prospectively enrolled (mean age was 66 ± 11.5 years, male 48%). Among them 132 patients have received additional ranolazine to the standard therapy while control group patients (n = 132) have received only standard therapy. Mean follow-up period was 5.0 ± 4.6 years. All statistical analyzes was performed using one sample student t-test. Results Initial baseline characteristics of patients were not statistically different. During the follow-up period in 8.3 % (n = 11) of patents have occurred MACE (AMI, PCI, CABG, death) in ranolazine group vs. in 9.8% (n = 13) of patients in the control group (P > 0.05). During the follow-up AF (paroxysmal and persistent) was developed significantly lower in ranolizine group than standard group (respectively: 13.6 % vs.18 percentage; P < 0.05). Sinus rhythm was recovered in the higher percent of patients in ranolazine group than standard group after cardioversion (89% vs. 79%, P < 0.05). Conclusion: Adding ranolazine to the standard treatment seems to have a beneficial role for the prevention of AF in high-risk patients with CCS and hypertension.

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