title: Ranolazine therapy in drug-refractory ventricular arrhythmias.
abstract: OBJECTIVE
  Ranolazine is an antiischemic and antianginal agent, but experimental and preclinical data provided evidence of additional antiarrhythmic properties. The aim of this study was to evaluate the safety and efficacy of ranolazine in reducing episodes of ventricular arrhythmias in patients with recurrent antiarrhythmic drug-refractory ventricular arrhythmias or with chronic angina.
  
  
  METHODS
  Seventeen implantable cardioverter defibrillator (ICD) recipients, who had experienced a worsening of their ventricular arrhythmia burden, and 12 ICD recipients with angina were enrolled. Patients were followed up for 6 months after the addition of ranolazine (postranolazine). Data were compared with before its administration (preranolazine).
  
  
  RESULTS
  In the Arrhythmias group, a significant reduction was found in the median number of ventricular tachycardia episodes per patient (4 vs. 0, P = 0.01), and in ICD interventions in terms of both antitachycardia pacing (2 vs. 0, P = 0.04) and shock delivery (2 vs. 0, P = 0.02) after the addition of ranolazine. Moreover, fewer patients experienced episodes of nonsustained ventricular tachycardia (71 vs. 41%, P = 0.04), ventricular tachycardia (76 vs. 24%, P = 0.01), ICD antitachycardia pacing (47 vs. 18%, P = 0.02), and ICD shocks (47 vs. 6%, P = 0.03). In the Angina group, none of the patients developed major ventricular arrhythmias while on ranolazine treatment. No adverse effects were observed.
  
  
  CONCLUSIONS
  In this small study, ranolazine proved to be effective, well tolerated, and safe in reducing ventricular arrhythmia episodes and ICD interventions in patients with recurrent antiarrhythmic drug-refractory events. In addition, none of the patients with chronic angina developed major ventricular arrhythmias.
authors.affiliation: aDivision of Cardiology, Spedali Civili Hospital, Brescia, Italy bCardiac Surgery Department, L.U.de.S. University, Lugano, Switzerland cClinical Research, Biotronik Italia, Milano, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Curnis
authors.forename: Francesca
authors.initials: F
authors.lastname: Salghetti
authors.forename: Manuel
authors.initials: M
authors.lastname: Cerini
authors.forename: Enrico
authors.initials: E
authors.lastname: Vizzardi
authors.forename: Edoardo
authors.initials: E
authors.lastname: Sciatti
authors.forename: Francesca
authors.initials: F
authors.lastname: Vassanelli
authors.forename: Clara
authors.initials: C
authors.lastname: Villa
authors.forename: Lorenza
authors.initials: L
authors.lastname: Inama
authors.forename: Abdallah
authors.initials: A
authors.lastname: Raweh
authors.forename: Daniele
authors.initials: D
authors.lastname: Giacopelli
authors.forename: Luca
authors.initials: L
authors.lastname: Bontempi
mesh_terms: D000368:Aged; D000889:Anti-Arrhythmia Agents / Q000009:adverse effects / Q000627:therapeutic use*; D017147:Defibrillators, Implantable; D018450:Disease Progression; D004351:Drug Resistance; D004554:Electric Countershock / Q000295:instrumentation*; D005260:Female; D006333:Heart Failure / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D000069458:Ranolazine / Q000009:adverse effects / Q000627:therapeutic use*; D012008:Recurrence; D017180:Tachycardia, Ventricular / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D013997:Time Factors; D016896:Treatment Outcome; D014693:Ventricular Fibrillation / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology
chemical_list: D000889:Anti-Arrhythmia Agents; D000069458:Ranolazine