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Protective therapy for atrial fibrillation with a late potassium channel blocker (pilot study)

Tatarsky B. A.
Federal State Budgetary Institution, “North-West Federal Medical Research Center” of the RF Ministry of Health Care, Akkuratova 2, St.-Petersburg 197341

Keywords: late sodium-channel blockers, treatment, ranolazine, atrial fibrillation

DOI: 10.18087/rhj.2014.2.1873

Background. Appropriate choice of anti-arrhythmic therapy reduces the risk associated with this therapy. The choice is especially difficult in treatment of atrial fibrillation (AF) in patients with CHF. Aim. To evaluate the efficacy of ranolazine as a possible choice of protective therapy in CHF patients with preserved systolic function and persistent AF. Materials and methods. 18 patients aged 40 to 67 years with documented, frequent episodes of recurrent AF and FC II–III CHF were evaluated. Recurrent AF persisted despite the anti-arrhythmic treatment. Ranolazine 500 mg bid was administered for 3 days prior to cardioversion (CV). If the therapy was well tolerated the dose was increased to 1000 mg bid for the entire follow-up period. Results. At 6 months, a response to ranolazine was observed in 12 of 14 patients. At the end of follow-up period, stable sinus rhythm was observed in 10 (71 %) patients; one patient had rare episodes of spontaneous AF arrest; three patients developed persistent, recurrent AF. After one year of the ranolazine treatment, a protective effect was observed in 11 (73 %) of 15 patients, who have restored their heart rhythm after elective CV. Conclusion. The ranolazine treatment can be protective in AF without pro-arrhythmic complications. Additional large-scale, randomized studies (including direct comparative studies) are required for evaluation of ranolazine efficacy and safety.
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Tatarsky B. A. Protective therapy for atrial fibrillation with a late potassium channel blocker (pilot study). Russian Heart Journal. 2014;76 (2):123–128

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