Background/Objective: Ranolazine is a new anti-ischemic agent approved for chronic angina with additional
electrophysiologic properties. The purpose of the present trial was to investigate its effect in preventing postoperative
atrial fibrillation (POAF) after on-pump coronary artery bypass graft (CABG) surgery.
Methods: In the current prospective, randomized, (1 active: 2 control), single-blind (outcome assessors), single-centre
clinical trial we recruited consecutive eligible patients scheduled for elective on-pump CABG. Participants were assigned
to receive either oral ranolazine 375 mg twice daily for 3 days prior to surgery and until discharge, or to receive usual
care. Patients were monitored for the development of POAF.
Results: We enrolled 102 patients. Significantly lower incidence of POAF was noted in the ranolazine group compared
with the control group (3 out of 34 patients, 8.8%, vs 21 out of 68 patients, 30.8%; p< 0.001). Mean values of left atrial
diameter and left ventricular ejection fraction between the control and the ranolazine group were not significantly different.
Conclusion: Our findings suggest a protective role of oral ranolazine when administered in a moderate dose preoperatively
in patients undergoing on-pump CABG surgery. Future studies based on a wider sample of patients will eventually
support our conclusions.