Aims: In several clinical and pre-clinical studies, application of ranolazine (RAN) led to suppression of atrial fibrillation (AF). The aim of the present study was to investigate whether RAN can suppress AF in an experimental rabbit whole heart model, in which acute haemodynamic changes trigger AF. Ranolazine was compared with flecainide and sotalol as established antiarrhythmic agents.
Methods And Results: In 60 Langendorff-perfused, isolated rabbit hearts, AF episodes were evoked by burst pacing with a fixed number of stimuli at baseline and following acute atrial stretch. Data were obtained in the absence and presence of acute dilatation of the left atrium (20 mmHg) at baseline and after drug application (RAN 10 µM, n = 10; flecainide 2 µM, n = 10; sotalol 50 µM, n = 10). Application of sotalol, but not RAN or flecainide increased the atrial action potential duration at 90% repolarization (aAPD90); however, both RAN (+8 ms) and flecainide (+13 ms) increased interatrial conduction time. All three drugs caused a significant increase in atrial effective refractory period (aERP) and, thus, an increase in atrial post-repolarization refractoriness (aPRR: +11 ms each, P < 0.05). Acute dilatation of the left atrium reduced aAPD90 and aERP. The described drug effects were preserved in the setting of acute atrial dilatation. Acute atrial dilatation significantly increased the incidence of AF. Ranolazine and flecainide, but not sotalol, decreased the number of responses.
Conclusion: Ranolazine-related sodium channel block is preserved upon acute atrial stretch. Ranolazine suppresses stretch-induced AF by increasing interatrial conduction time and aPRR. These results shed further evidence on the potential role of RAN in the prevention of AF. This might also apply to clinical conditions that are associated with haemodynamic or mechanical disorders, leading to acute dilatation of the atria.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1093/europace/eus399 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Pulmonary hypertension in infancy: a reversible cause.
BMJ Case Rep
January 2025
Pediatrics, The University of Tennessee Health Science Center, Memphis, Tennessee, USA.
A term, healthy infant presented with respiratory distress and severe pulmonary hypertension (PH). With an unclear aetiology and the intent to decrease right ventricular afterload, pulmonary vasodilators were initiated. Follow-up imaging revealed a supravalvular mitral ring as the cause of the PH which resolved after surgical resection of the membrane.
View Article and Find Full Text PDFThe prognostic and diagnostic significance of echocardiographic parameters on acute ischemic stroke.
J Stroke Cerebrovasc Dis
January 2025
Department of Neurology and Clinical Research Center of Neurological Disease, The Second Affiliated Hospital of Soochow University, Suzhou City, Jiangsu Province, China. Electronic address:
Objective: To comprehensively explore the prognostic significance of transthoracic echocardiography (TTE) and three-dimensional speckle-tracking echocardiography (3D STE) parameters in AIS and their role in distinguishing cardioembolic stroke.
Methods: 301 acute ischemic stroke (AIS) patients were enrolled. TTE and 3D STE were employed to evaluate cardiac function and structure, also left atrial strain.
Early Left Ventricular Unloading after Venoarterial Extracorporeal Membrane Oxygenation: One-Year Outcomes of the EARLY-UNLOAD Randomized Clinical Trial.
Eur Heart J Acute Cardiovasc Care
January 2025
Division of Cardiology, Department of Internal Medicine, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, South Korea.
Background: The long-term effects of early left ventricular unloading after venoarterial extracorporeal membrane oxygenation (VA-ECMO) remain unclear.
Methods: The EARLY-UNLOAD trial was a single-center, investigator-initiated, open-label, randomized clinical trial involving 116 patients with cardiogenic shock (CS) undergoing VA-ECMO. The patients were randomly assigned to undergo either early routine left ventricular unloading by transseptal left atrial cannulation within 12 hours after randomization or the conventional approach, which permitted rescue transseptal cannulation in case of an increased left ventricular afterload.
Risk factors and characteristics of preoperative heart failure in elderly patients with hip fracture and the influence of anemia on prognosis.
BMC Musculoskelet Disord
January 2025
Department of Geriatric Orthopedics, The Third Hospital of Hebei MedicalUniversity, No.139 ZiQiang Lu, Shijiazhuang, Hebei, 050051, PR China.
Background: Patients with preoperative acute heart failure (AHF) after hip fracture in the elderly have a worse prognosis. We aim to investigate the characteristics, risk factors and postoperative complications of elderly patients with hip fracture complicated with preoperative AHF. We also looked at the effect of the severity of anemia at admission on the prognosis of the above people.
View Article and Find Full Text PDFPre-stroke patient characteristics that influence skeletal muscle quality: A cross-sectional study.
Geriatr Gerontol Int
January 2025
Department of Rehabilitation Medicine, Hyogo Medical University, Nishinomiya, Japan.
Aim: One of the parameters that is measurable using bioelectrical impedance is the phase angle (PhA), which is an indicator of skeletal muscle quality. The PhA reflects cellular health and nutritional status and is an important parameter for monitoring recovery after stroke. However, the factors affecting skeletal muscle quality remain unclear.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!