title: The electrophysiological properties of ranolazine: a metabolic anti-ischemic drug or an energy-efficient antiarrhythmic agent?
abstract: Ranolazine, a newer anti-ischemic agent that appears to induce a more efficient utilization         of adenosine triphosphate at the cellular level, has been shown to be clinically         beneficial in patients with chronic stable angina. More recently, the antiarrhythmic         effects of the drug have been described in patients with acute coronary syndromes, as         well as in those with atrial fibrillation, when combined with other agents. Experimentally,         the predominant inhibitory effects on late I(Na), I(Ca), I(Na-Ca), and I(Ks), with little or no         effect on I(to) or I(K1), have been demonstrated. Different experimental models have shown         the potential beneficial effect of the drug in both supraventricular and ventricular         arrhythmias. Interestingly, despite its potential prolongation of the QT interval,         ranolazine does not appear to induce ventricular arrhythmias in animal models.         Whether the antiarrhythmic effect is secondary to a more efficient energy production         by the cardiac cell or by its direct effect on ion channels is still unclear. The effect of         ranolazine on other ionic currents, as well as its potential as a clinically relevant         antiarrhythmic agent, still needs to be studied.
authors.affiliation: Cedars-Sinai Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
authors.forename: Eugenio
authors.initials: E
authors.lastname: Cingolani
authors.forename: Norman E
authors.initials: NE
authors.lastname: Lepor
authors.forename: Bramah N
authors.initials: BN
authors.lastname: Singh
mesh_terms: D000083:Acetanilides / Q000627:therapeutic use*; D000818:Animals; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use*; D001145:Arrhythmias, Cardiac / Q000188:drug therapy* / Q000378:metabolism / Q000503:physiopathology; D004734:Energy Metabolism / Q000187:drug effects*; D006329:Heart Conduction System / Q000187:drug effects* / Q000378:metabolism / Q000503:physiopathology; D006801:Humans; D017202:Myocardial Ischemia / Q000188:drug therapy* / Q000378:metabolism / Q000503:physiopathology; D009206:Myocardium / Q000378:metabolism*; D010879:Piperazines / Q000627:therapeutic use*; D000069458:Ranolazine
chemical_list: D000083:Acetanilides; D000889:Anti-Arrhythmia Agents; D010879:Piperazines; D000069458:Ranolazine