Moreover all the anti-arrhythmic agents that are used in treatment of AF were potentially pro-arrhythmic especially in patients with coronary artery disease and structurally abnormal heart .
Although atrial fibrillation ( AF ) is the most common sustained arrhythmia seen during daily cardiovascular physician practice , its management remained a challenge for cardiology physician as there was no single anti-arrhythmic agents proved to be effective in converting atrial fibrillation and kept its effectiveness in maintaining sinus rhythm over long term .
Some of these drugs also have serious non cardiac side effects that limit its long term use in the management of atrial fibrillation .
Several new and investigational anti-arrhythmic agents are emerging but data supporting their effectiveness and safety are still limited .
Comparison of effectiveness and safety of ranolazine versus amiodarone for preventing atrial fibrillation after coronary artery bypass grafting.
Atrial  fibrillation ( AF )  is common after coronary artery bypass grafting ( CABG ) and increases the morbidity and cost . Amiodarone reduces AF after CABG . Ranolazine , an antianginal agent , also prolongs atrial refractoriness and inhibits after depolarizations and triggered activity ; effects that could decrease AF after CABG . The present study compared amiodarone versus ranolazine for the prevention of AF after CABG . A retrospective cohort study of patients undergoing CABG at Aspirus Hospital from June 2008 to April 2010 . The patients received either amiodarone ( 400 mg preoperatively followed by 200 mg twice daily for 10 to 14 days ) or ranolazine ( 1,500 mg preoperatively followed by 1,000 mg twice daily for 10 to 14 days ) . The primary end point was any identified AF after CABG . A total of 393 consecutive patients undergoing CABG ( mean age 65 ± 10 years , 72 % men ) received either amiodarone ( n = 211 [ 53.7 % ] ) or ranolazine ( n = 182 [ 46.3 % ] ) . AF occurred in 26.5 % of the amiodarone-treated patients compared to 17.5 % of the ranolazine-treated patient ( p = 0.035 ) . The univariate predictors of AF included amiodarone use , age , chronic lung disease , and congestive heart failure . The multivariate predictors of AF included amiodarone use ( odds ratio 1.7 , 95 % confidence interval 1.01 to 2.91 , p = 0.045 vs ranolazine ) , age ( odds ratio 2.2 per 10 years , 95 % confidence interval 1.63 to 2.95 , p < 0.001 ) , and chronic lung disease ( odds ratio 1.86 , 95 % confidence interval 1.00 to 3.43 , p = 0.049 ) . No difference was found in the risk of adverse events between the 2 therapies . In conclusion , ranolazine was independently associated with a significant reduction of AF compared to amiodarone after CABG , with no difference in the incidence of adverse events . R and omized studies should be conducted to confirm these results
Moreover all the anti-arrhythmic agents that are used in treatment of AF were potentially pro-arrhythmic especially in patients with coronary artery disease and structurally abnormal heart .
Although atrial fibrillation ( AF ) is the most common sustained arrhythmia seen during daily cardiovascular physician practice , its management remained a challenge for cardiology physician as there was no single anti-arrhythmic agents proved to be effective in converting atrial fibrillation and kept its effectiveness in maintaining sinus rhythm over long term .
Some of these drugs also have serious non cardiac side effects that limit its long term use in the management of atrial fibrillation .
Several new and investigational anti-arrhythmic agents are emerging but data supporting their effectiveness and safety are still limited .