Role of Ranolazine in the Prevention and Treatment of Atrial Fibrillation in Patients with Left Ventricular Systolic Dysfunction: A Meta-Analysis of Randomized Clinical Trials
Background: Ranolazine has the potential to prevent atrial fibrillation (AF) and plays a role in rhythm control strategy for atrial fibrillation in various clinical settings. However, data on the use of ranolazine in patients with left ventricular (LV) systolic dysfunction are limited. The aims of t...
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MDPI AG
2021-04-01
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| Online Access: | https://www.mdpi.com/2079-9721/9/2/31 |
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| author | Pattranee Leelapatana Charat Thongprayoon Narut Prasitlumkum Saraschandra Vallabhajosyula Wisit Cheungpasitporn Ronpichai Chokesuwattanaskul |
| author_facet | Pattranee Leelapatana Charat Thongprayoon Narut Prasitlumkum Saraschandra Vallabhajosyula Wisit Cheungpasitporn Ronpichai Chokesuwattanaskul |
| author_sort | Pattranee Leelapatana |
| collection | DOAJ |
| description | Background: Ranolazine has the potential to prevent atrial fibrillation (AF) and plays a role in rhythm control strategy for atrial fibrillation in various clinical settings. However, data on the use of ranolazine in patients with left ventricular (LV) systolic dysfunction are limited. The aims of this meta-analysis of randomized clinical trials are to investigate the efficacy and safety of ranolazine in AF patients with LV systolic dysfunction. PubMed and the Cochrane Database of Systematic Reviews were searched until July 2020. The efficacy outcomes included the incidence of new-onset AF, the rate of sinus rhythm restoration, and the time until sinus rhythm restoration. Safety endpoints were at death, and any adverse events were reported in the enrolled studies. We initially identified 204 studies and finally retrieved 5 RCTs. Three studies were analyzed in the meta-analysis. Among AF patients with LV systolic dysfunction, our meta-analysis showed that the combination of ranolazine to amiodarone significantly increased the sinus rhythm restoration rate compared to amiodarone alone (risk ratio (RR) 2.87, 95% confidence interval (CI) 2.48–3.32). Moreover, the time to sinus rhythm restoration was 2.46 h shorter in the ranolazine added to amiodarone group (95% CI: 2.27–2.64). No significant adverse events and proarrhythmias in the ranolazine group were identified. In conclusion, in AF patients with LV systolic dysfunction, ranolazine as an add-on therapy to amiodarone potentiates and accelerates the conversion of AF to sinus rhythm. Moreover, ranolazine shows good safety profiles. Further studies to investigate the effectiveness of ranolazine in the prevention of new-onset AF among patients with LV systolic dysfunction are needed. |
| first_indexed | 2024-03-10T12:16:45Z |
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| language | English |
| last_indexed | 2024-03-10T12:16:45Z |
| publishDate | 2021-04-01 |
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| series | Diseases |
| spelling | doaj.art-c3d39fce6a8c4a2c96297dee805206fe2023-11-21T15:48:26ZengMDPI AGDiseases2079-97212021-04-01923110.3390/diseases9020031Role of Ranolazine in the Prevention and Treatment of Atrial Fibrillation in Patients with Left Ventricular Systolic Dysfunction: A Meta-Analysis of Randomized Clinical TrialsPattranee Leelapatana0Charat Thongprayoon1Narut Prasitlumkum2Saraschandra Vallabhajosyula3Wisit Cheungpasitporn4Ronpichai Chokesuwattanaskul5Cardiac Center, Division of Cardiovascular Medicine, Department of Internal Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok 10330, ThailandDivision of Nephrology and Hypertension, Mayo Clinic, Rochester, MN 55905, USADivision of Cardiology, University of California Riverside, Riverside, CA 92521, USASection of Interventional Cardiology, Division of Cardiovascular Medicine, Department of Medicine, Emory University School of Medicine, Atlanta, GA 30322, USADivision of Nephrology and Hypertension, Mayo Clinic, Rochester, MN 55905, USACardiac Center, Division of Cardiovascular Medicine, Department of Internal Medicine, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok 10330, ThailandBackground: Ranolazine has the potential to prevent atrial fibrillation (AF) and plays a role in rhythm control strategy for atrial fibrillation in various clinical settings. However, data on the use of ranolazine in patients with left ventricular (LV) systolic dysfunction are limited. The aims of this meta-analysis of randomized clinical trials are to investigate the efficacy and safety of ranolazine in AF patients with LV systolic dysfunction. PubMed and the Cochrane Database of Systematic Reviews were searched until July 2020. The efficacy outcomes included the incidence of new-onset AF, the rate of sinus rhythm restoration, and the time until sinus rhythm restoration. Safety endpoints were at death, and any adverse events were reported in the enrolled studies. We initially identified 204 studies and finally retrieved 5 RCTs. Three studies were analyzed in the meta-analysis. Among AF patients with LV systolic dysfunction, our meta-analysis showed that the combination of ranolazine to amiodarone significantly increased the sinus rhythm restoration rate compared to amiodarone alone (risk ratio (RR) 2.87, 95% confidence interval (CI) 2.48–3.32). Moreover, the time to sinus rhythm restoration was 2.46 h shorter in the ranolazine added to amiodarone group (95% CI: 2.27–2.64). No significant adverse events and proarrhythmias in the ranolazine group were identified. In conclusion, in AF patients with LV systolic dysfunction, ranolazine as an add-on therapy to amiodarone potentiates and accelerates the conversion of AF to sinus rhythm. Moreover, ranolazine shows good safety profiles. Further studies to investigate the effectiveness of ranolazine in the prevention of new-onset AF among patients with LV systolic dysfunction are needed.https://www.mdpi.com/2079-9721/9/2/31atrial fibrillationranolazinesystolic dysfunctionheart failuremeta-analysis |
| spellingShingle | Pattranee Leelapatana Charat Thongprayoon Narut Prasitlumkum Saraschandra Vallabhajosyula Wisit Cheungpasitporn Ronpichai Chokesuwattanaskul Role of Ranolazine in the Prevention and Treatment of Atrial Fibrillation in Patients with Left Ventricular Systolic Dysfunction: A Meta-Analysis of Randomized Clinical Trials Diseases atrial fibrillation ranolazine systolic dysfunction heart failure meta-analysis |
| title | Role of Ranolazine in the Prevention and Treatment of Atrial Fibrillation in Patients with Left Ventricular Systolic Dysfunction: A Meta-Analysis of Randomized Clinical Trials |
| title_full | Role of Ranolazine in the Prevention and Treatment of Atrial Fibrillation in Patients with Left Ventricular Systolic Dysfunction: A Meta-Analysis of Randomized Clinical Trials |
| title_fullStr | Role of Ranolazine in the Prevention and Treatment of Atrial Fibrillation in Patients with Left Ventricular Systolic Dysfunction: A Meta-Analysis of Randomized Clinical Trials |
| title_full_unstemmed | Role of Ranolazine in the Prevention and Treatment of Atrial Fibrillation in Patients with Left Ventricular Systolic Dysfunction: A Meta-Analysis of Randomized Clinical Trials |
| title_short | Role of Ranolazine in the Prevention and Treatment of Atrial Fibrillation in Patients with Left Ventricular Systolic Dysfunction: A Meta-Analysis of Randomized Clinical Trials |
| title_sort | role of ranolazine in the prevention and treatment of atrial fibrillation in patients with left ventricular systolic dysfunction a meta analysis of randomized clinical trials |
| topic | atrial fibrillation ranolazine systolic dysfunction heart failure meta-analysis |
| url | https://www.mdpi.com/2079-9721/9/2/31 |
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