title: Role of ranolazine in the prevention and treatment of atrial fibrillation: A meta-analysis of randomized clinical trials.
abstract: Randomized controlled trials (RCTs) on the use of ranolazine (RN) for prevention and cardioversion of atrial fibrillation (AF) have yielded conflicting results.
  
  
  
  The purpose of this study was to conduct a meta-analysis of RCTs to examine the potential role of RN in the prevention and cardioversion of AF.
  
  
  
  PubMed and EMBASE were searched until June 2016. Of 484 initially identified studies, 8 RCTs were finally analyzed.
  
  
  
  The analysis of RCTs showed that RN significantly reduced the incidence of AF compared to the control group in various clinical settings, such as after cardiac surgery, in acute coronary syndromes, and post-electrical cardioversion of AF (relative risk [RR] 0.67, 95% confidence interval [CI] 0.52-0.87, Z = 3.06, P = .002). Furthermore, a higher conversion rate of AF from the combined use of RN and amiodarone compared to amiodarone alone (RR 1.23, 95% CI 1.08-1.40, Z = 3.07, P = .002) was clear, with conversion time significantly shorter in RN plus amiodarone compared to the amiodarone group (weighted mean difference [WMD] = -10.38 hours, 95% CI -18.18 to -2.57, Z = 2.61, P = .009).
  
  
  
  Our meta-analysis suggests that RN may be effective in AF prevention, whereas it potentiates and accelerates the conversion effect of amiodarone of recent-onset AF. Larger RCTs with long-term follow-up in diverse clinical settings are needed to further clarify the impact of RN on AF therapy.
authors.affiliation: Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin, People's Republic of China.
authors.forename: Mengqi
authors.initials: M
authors.lastname: Gong
authors.affiliation: Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin, People's Republic of China.
authors.forename: Zhiwei
authors.initials: Z
authors.lastname: Zhang
authors.affiliation: Third Cardiology Department, Hippokrateion Hospital, Aristotle University, Medical School, Thessaloniki, Greece.
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Fragakis
authors.affiliation: First Department of Cardiology, University of Ioannina Medical School, Ioannina, Greece.
authors.forename: Panagiotis
authors.initials: P
authors.lastname: Korantzopoulos
authors.affiliation: Second Department of Cardiology, Laboratory of Cardiac Electrophysiology, "Evangelismos" General Hospital of Athens, Athens, Greece.
authors.forename: Konstantinos P
authors.initials: KP
authors.lastname: Letsas
authors.affiliation: Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin, People's Republic of China.
authors.forename: Guangping
authors.initials: G
authors.lastname: Li
authors.affiliation: Lankenau Institute for Medical Research and Lankenau Medical Center, Wynnewood, Pennsylvania,; Beijing Anzhen Hospital, Capital Medical University, Beijing, China. Electronic address: YanG@mlhs.org.
authors.forename: Gan-Xin
authors.initials: GX
authors.lastname: Yan
authors.affiliation: Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin, People's Republic of China. Electronic address: liutongdoc@126.com.
authors.forename: Tong
authors.initials: T
authors.lastname: Liu
mesh_terms: D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use*; D001281:Atrial Fibrillation / Q000188:drug therapy* / Q000401:mortality / Q000517:prevention & control*; D004554:Electric Countershock / Q000379:methods*; D004562:Electrocardiography / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D011379:Prognosis; D016032:Randomized Controlled Trials as Topic; D000069458:Ranolazine / Q000627:therapeutic use*; D018570:Risk Assessment; D012720:Severity of Illness Index; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D000889:Anti-Arrhythmia Agents; D000069458:Ranolazine
keywords: Atrial fibrillation; Late sodium current; Meta-analysis; Ranolazine