title: Ranolazine reduces atrial fibrillatory wave frequency.
abstract: OBJECTIVE
  Antiarrhythmic medications for the treatment of atrial fibrillation (AF) have limited efficacy and rare but potentially life-threatening side effects. Ranolazine is an antianginal agent that may have antiarrhythmic activity in AF.
  
  
  RESULTS
  Using the Duke Enterprise Data Unified Content Explorer database, we analysed a cohort of AF patients on ranolazine. Patients served as their own historic control. Electrocardiograms (ECGs) were analysed before and after ranolazine initiation to determine the effect of ranolazine on dominant frequency (DF), f-wave amplitude, and organizational index (OI). We identified 15 patients with ECGs in AF before and after ranolazine. Ranolazine was associated with lower DF by an average of 10% (5.10 ± 0.74 vs. 5.79 ± 0.96 Hz, P = 0.04) but not with changes in OI (0.47 ± 0.11 vs. 0.50 ± 0.12, P = 0.71) or amplitude (0.47 ± 0.43 vs. 0.41 ± 0.40 mV, P = 0.82). Ranolazine was also associated with lower DF in patients (n = 10) not on concomitant antiarrhythmic therapy (5.25 ± 0.78 vs. 6.03 ± 0.79 Hz, P = 0.04).
  
  
  CONCLUSIONS
  Ranolazine is associated with lower AF DF but no change in OI or fibrillatory wave amplitude. Prospective trials are needed to evaluate ranolazine's potential as a novel antiarrhythmic drug for AF.
authors.affiliation: Duke Center for Atrial Fibrillation and Cardiac Electrophysiology Section, Duke University Medical Center, Duke Clinical Research Institute, PO Box 17969, Durham, NC 27710, USA.
authors.forename: Eric W
authors.initials: EW
authors.lastname: Black-Maier
authors.affiliation: Duke Center for Atrial Fibrillation and Cardiac Electrophysiology Section, Duke University Medical Center, Duke Clinical Research Institute, PO Box 17969, Durham, NC 27710, USA.
authors.forename: Sean D
authors.initials: SD
authors.lastname: Pokorney
authors.affiliation: Duke Center for Atrial Fibrillation and Cardiac Electrophysiology Section, Duke University Medical Center, Duke Clinical Research Institute, PO Box 17969, Durham, NC 27710, USA.
authors.forename: Adam S
authors.initials: AS
authors.lastname: Barnett
authors.affiliation: Duke Center for Atrial Fibrillation and Cardiac Electrophysiology Section, Duke University Medical Center, Duke Clinical Research Institute, PO Box 17969, Durham, NC 27710, USA.
authors.forename: Peter
authors.initials: P
authors.lastname: Liu
authors.affiliation: Duke Center for Atrial Fibrillation and Cardiac Electrophysiology Section, Duke University Medical Center, Duke Clinical Research Institute, PO Box 17969, Durham, NC 27710, USA.
authors.forename: Peter
authors.initials: P
authors.lastname: Shrader
authors.affiliation: Northwestern University, Chicago, IL, USA.
authors.forename: Jason
authors.initials: J
authors.lastname: Ng
authors.affiliation: University of Miami, Miami, FL, USA.
authors.forename: Jeffrey J
authors.initials: JJ
authors.lastname: Goldberger
authors.affiliation: University of Rochester, Rochester, NY, USA.
authors.forename: Wojiech
authors.initials: W
authors.lastname: Zareba
authors.affiliation: Duke Center for Atrial Fibrillation and Cardiac Electrophysiology Section, Duke University Medical Center, Duke Clinical Research Institute, PO Box 17969, Durham, NC 27710, USA.
authors.forename: James P
authors.initials: JP
authors.lastname: Daubert
authors.affiliation: Duke Center for Atrial Fibrillation and Cardiac Electrophysiology Section, Duke University Medical Center, Duke Clinical Research Institute, PO Box 17969, Durham, NC 27710, USA.
authors.forename: Augustus O
authors.initials: AO
authors.lastname: Grant
authors.affiliation: Duke Center for Atrial Fibrillation and Cardiac Electrophysiology Section, Duke University Medical Center, Duke Clinical Research Institute, PO Box 17969, Durham, NC 27710, USA.
authors.forename: Jonathan P
authors.initials: JP
authors.lastname: Piccini
mesh_terms: D000200:Action Potentials; D000368:Aged; D000369:Aged, 80 and over; D000889:Anti-Arrhythmia Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D016208:Databases, Factual; D004562:Electrocardiography; D005260:Female; D006329:Heart Conduction System / Q000187:drug effects* / Q000503:physiopathology; D006339:Heart Rate / Q000187:drug effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009657:North Carolina; D000069458:Ranolazine / Q000009:adverse effects / Q000627:therapeutic use*; D012189:Retrospective Studies; D026941:Sodium Channel Blockers / Q000009:adverse effects / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D000889:Anti-Arrhythmia Agents; D026941:Sodium Channel Blockers; D000069458:Ranolazine
keywords: Antiarrhythmic; Atrial fibrillation; Dominant frequency; Ranolazine; f-wave