The use of ranolazine to facilitate electrical cardioversion in cardioversion-resistant patients: a case series.

Background: Occasionally atrial fibrillation (AF) is resistant to electrical cardioversion (EC). Ranolazine (RZ) is an antianginal agent, which inhibits abnormal late Na(+) channel currents in cardiomyocytes and decreases Na(+) /Ca(++) overload. RZ is a potent inhibitor of after-depolarizations and triggered activity and prolongs atrial refractory periods.

Suppression of frequent ventricular ectopy in a patient with hypertrophic heart disease with ranolazine: a case report.

Background: Pro-arrhythmic concerns with most anti-arrhythmic agents in patients with significant left ventricular hypertrophy (LVH) limits options when anti-arrhythmic therapy is indicated. Ranolazine, an anti-anginal agent which inhibits late Na+ currents, indirectly causes a decrease in diastolic cardiomyocyte Ca++ levels producing an energy sparing effect. Ranolazine also inhibits triggered activity in animal studies and has anti-arrhythmic properties in patients with ischemic heart disease.

Electrophysiological Changes of the Atrium in Patients with Lone Paroxysmal Atrial Fibrillation.

Background: The "Pill-in-Pocket" (PIP) is an approach to atrial fibrillation (AF) where oral anti-arrhythmics at 75% to 100% of the normal daily dose, given as a single dose, is used to convert recent-onset AF. Pro-arrhythmic risk has limited this approach to patients without structural heart disease (SHD). Ranolazine is an anti-anginal agent, which inhibits the abnormal late Na+ channel current resulting in decreased Na+/Ca++ overload.

Suppression of non-sustained ventricular tachycardia with ranolazine: a case report.

Background: Ranolazine is a new anti-anginal agent that inhibits abnormal late sodium currents, indirectly causing a decrease in diastolic cardiomyocyte calcium levels. This produces an energy-sparing effect and stabilizes cardiac membranes. Ranolazine has been shown to be a potent inhibitor of triggered activity in the experimental setting.

The use of oral ranolazine to convert new or paroxysmal atrial fibrillation: a review of experience with implications for possible "pill in the pocket" approach to atrial fibrillation.

Background: Atrial fibrillation (AF) is the most common arrhythmia requiring treatment. High dose oral anti-arrhythmics may cardiovert some paroxysmal AF. This "pill in pocket" approach has allowed patients to treat themselves on an as needed basis.