title: Ranolazine enhances the antiarrhythmic activity of amiodarone by accelerating conversion of new-onset atrial fibrillation after cardiac surgery.
abstract: Ranolazine is a relatively novel antiischemic/antianginal compound with antiarrhythmic properties. We investigated its ability to shorten the time to conversion of postoperative atrial fibrillation (POAF) when added to amiodarone after coronary artery bypass graft (CABG) surgery. In this prospective, randomized, allocation-concealed, single-blind, single-site clinical trial, we enrolled consecutive eligible patients who developed POAF after elective on-pump CABG surgery. Participants were randomized to receive either ranolazine 375 mg twice daily orally plus intravenous amiodarone (active group) or intravenous amiodarone alone (control group). We enrolled 41 patients; 20 in the active and 21 in the control group. There were no significant differences between the groups in terms of age, procedural duration, extracorporeal circulation time, and aortic cross-clamp time. Mean time of conversion was significantly shorter in the active group (19.9 ± 3.2 vs 37.2 ± 3.9 hours, P < .001), suggesting that compared to amiodarone alone, the ranolazine-amiodarone combination had a superior antiarrhythmic effect against POAF.
authors: 1Department of Cardiovascular and Thoracic Surgery, University of Thessaly, Larissa, Greece.
authors: Vassilios
authors: V
authors: Simopoulos
authors: Georgios I
authors: GI
authors: Tagarakis
authors: Stella S
authors: SS
authors: Daskalopoulou
authors: Marios E
authors: ME
authors: Daskalopoulos
authors: Aristidis
authors: A
authors: Lenos
authors: Konstantinos
authors: K
authors: Chryssagis
authors: Ioannis
authors: I
authors: Skoularingis
authors: Paschalis-Adam
authors: PA
authors: Molyvdas
authors: Nikolaos B
authors: NB
authors: Tsilimingas
authors: Isaac
authors: I
authors: Aidonidis
mesh_terms: D000083:Acetanilides / Q000008:administration & dosage*; D000284:Administration, Oral; D000368:Aged; D000638:Amiodarone / Q000008:administration & dosage*; D000889:Anti-Arrhythmia Agents / Q000008:administration & dosage*; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D002315:Cardiopulmonary Bypass / Q000009:adverse effects; D001026:Coronary Artery Bypass / Q000009:adverse effects*; D004334:Drug Administration Schedule; D004357:Drug Synergism; D004359:Drug Therapy, Combination; D017558:Elective Surgical Procedures; D005260:Female; D006115:Greece; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D010879:Piperazines / Q000008:administration & dosage*; D011446:Prospective Studies; D000069458:Ranolazine; D016037:Single-Blind Method; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000083:Acetanilides; D000889:Anti-Arrhythmia Agents; D010879:Piperazines; D000069458:Ranolazine; D000638:Amiodarone
keywords: amiodarone; atrial fibrillation; cardiac surgery; postoperative atrial fibrillation; ranolazine