Abstract 13387: Effect of Ranolazine on the Incidence of Atrial Fibrillation Following Cardiac Surgery

• DOI: 10.1161/circ.132.suppl_3.13387
• Publication Date: 2024-04-23T10:56:22Z
• Authors: Soad Bekeith; Mustafain Meghani; Masood A Shariff; Deepak Asti; Nikhil Nalluri; Vratika Agarwal; Neeraj Shah; Armaghan Soomro; Muzaffar Khan; Johnathan Spagnola; Carmen Chan; Elaena Quattrocchi; Elias Youssef; John P Nabagiez; Joseph T McGinn
• Keywords: Ranolazine

Introduction: Atrial fibrillation (AF) is common following cardiac surgery. Reduction of postoperative AF would decrease average length stay and improve patient outcomes. Ranolazine has been shown to prevent by increasing postrepolarization refractoriness in atrial tissue. This study evaluates prophylactic ranolazine on Hypothesis: To assess the effect as a selective sodium channel blocker prevention Methods: double blinded, randomized trial assessed primary with patients undergoing coronary artery bypass grafting (CABG) and/or aortic valve replacement (AVR) from 2012-13. Mitral surgery was an exclusion criterion. Fifty-four were randomly allocated twice daily 1000 mg (n=27) or placebo 48 hours prior surgical intervention postoperatively for 14 days. Cardiac monitoring arrhythmias continued 2 weeks post discharge using Holter monitor. The endpoint up day 14. Secondary endpoints included 30 readmission, complications, stay. (ClinicalTrials.gov: NCT01590979). Results: Fifty-one completed days postoperatively. Cohort mean age 64.3±11.4 years, females 10(19%), ejection fraction 46.4±14.6%, hypertension 48(89%), dyslipidemia 32(59%) diabetes 22 (41%), no difference between groups. Patients underwent isolated CABG (44, 81%), AVR (4, 7%) combined AVR/CABG (3, 6%). incidence 24%, control 8 (30%) treated 5 (19%) groups, 38% reduction, not statistically significant (p=0.530). QT duration longer group (p=0.014). who developed significantly (8.3±5.0 vs. 5.4±2.7, p=0.009), drug related adverse events. Conclusion: illustrates prevalence antianginal medication that can be used safely reduce AF. In conclusion, this showed reduction 38%. Although significant, indicates trend towards our hypothesis.