Randomized controlled trials ( RCTs ) regarding use of Ranolazine for the prevention and cardioversion of atrial fibrillation have yielded conflicting results.
Researchers have conducted a meta-analysis of randomized controlled trials to examine the potential role of Ranolazine in the prevention and cardioversion of atrial fibrillation.
Of 484 initially identified studies, eight randomized controlled trials were finally analyzed.
The analysis of randomized controlled trials showed that Ranolazine significantly reduced the incidence of atrial fibrillation compared to the control group in various clinical settings as following cardiac surgery, in acute coronary syndromes, and post electrical cardioversion of atrial fibrillation ( RR = 0.67, 95% CI: 0.52, 0.87, Z = 3.06, P = 0.002 ).
Furthermore, a higher conversion rate of atrial fibrillation from the combined use of Ranolazine and Amiodarone compared to Amiodarone alone ( RR = 1.23, 95% CI: 1.08, 1.40, Z = 3.07, P = 0.002 ) was clear with conversion time significantly shorter in Ranolazine plus Amiodarone compared to Amiodarone group ( WMD = -10.38 hours, 95% CI: -18.18, -2.57, Z = 2.61, P = 0.009 ).
The meta-analysis has shown that Ranolazine may be effective in atrial fibrillation prevention whereas it potentiates and accelerates the conversion effect of Amiodarone of recent onset atrial fibrillation.
Larger randomized controlled trials with long-term follow-up in diverse clinical settings are needed to further clarify the impact of Ranolazine on atrial fibrillation therapy. ( Xagena )
Gong M et al, Heart Rhythm 2016; Epub ahead of print