title: Use of ranolazine in the prevention and treatment of postoperative atrial fibrillation in patients undergoing cardiac surgery.
abstract: OBJECTIVE
  To determine the evidence for use of ranolazine for treatment and prevention of postoperative atrial fibrillation (POAF) in patients undergoing cardiac surgery.
  
  
  METHODS
  A literature search of MEDLINE (1946 to January 2014) was conducted, using the search terms ranolazine, atrial fibrillation, and cardiac surgery. A search of reference citations was conducted to identify additional references.
  
  
  METHODS
  Clinical trials investigating the use of ranolazine for POAF were included in the review.
  
  
  RESULTS
  Three clinical trials were reviewed; 2 trials, 1 retrospective and 1 prospective, compared ranolazine with amiodarone or usual care for prevention of POAF and demonstrated a significant decrease in the incidence of POAF without increasing the incidence of postoperative complications. A third prospective trial used ranolazine in combination with amiodarone for the treatment of POAF and demonstrated a significant reduction in the time required to convert patients from atrial fibrillation to normal sinus rhythm compared with amiodarone alone.
  
  
  CONCLUSIONS
  In these current small trials, ranolazine appears to be a safe and efficacious therapeutic alternative for the treatment and prevention of POAF in patients undergoing cardiac surgery. However, larger randomized controlled trials are needed before ranolazine should be considered for the treatment or prevention of POAF. It is an attractive option compared with current treatments for this indication-primarily β-blockers and amiodarone-because ranolazine has minimal effects on heart rate and blood pressure.
authors: Midwestern University College of Pharmacy Glendale, AZ, USA.
authors: Laura V
authors: LV
authors: Tsu
authors: Stacy
authors: S
authors: Lee
mesh_terms: D000083:Acetanilides / Q000627:therapeutic use*; D001281:Atrial Fibrillation / Q000188:drug therapy / Q000517:prevention & control*; D006348:Cardiac Surgical Procedures / Q000009:adverse effects; D006801:Humans; D010879:Piperazines / Q000627:therapeutic use*; D011183:Postoperative Complications / Q000517:prevention & control*; D000069458:Ranolazine; D026941:Sodium Channel Blockers / Q000627:therapeutic use*
chemical_list: D000083:Acetanilides; D010879:Piperazines; D026941:Sodium Channel Blockers; D000069458:Ranolazine
keywords: cardiac surgery; coronary artery bypass graft; postoperative atrial fibrillation; ranolazine