Murai Kyosuke, Vasigh Amir, Alexy Tamás, Tóth Kálmán, Czopf László
1st Department of Medicine, Medical School, University of Pécs, Ifjúság útja 13, H-7624 Pécs, Hungary.
Department of Medicine, Division of Cardiology, University of Minnesota, Minneapolis, MN 55127, USA.
Biomedicines. 2024 Jul 26;12(8):1669. doi: 10.3390/biomedicines12081669.
Cardiac arrhythmias are among the leading causes of morbidity and mortality worldwide. While antiarrhythmic drugs traditionally represent the first-line management strategy, their use is often limited by profound proarrhythmic effects. Several studies, including randomized control trials (RCTs), have demonstrated the antiarrhythmic efficacy of ranolazine, which is registered as an antianginal agent, while also establishing its safety profile. This review compiles clinical evidence investigating the antiarrhythmic properties of ranolazine, focusing primarily on ventricular tachycardia (VT) and atrial fibrillation (AF), as they are common rhythm abnormalities with serious complications. Data from RCTs indicate that ranolazine reduces VT incidence, although this effect is not universal. Therefore, we attempt to better describe the patient population that gains the most benefit from ranolazine due to VT suppression. Additionally, ranolazine is known to enhance the conversion rate of AF to sinus rhythm when combined with other antiarrhythmic drugs such as amiodarone, highlighting its synergistic effect in the atrium without provoking ventricular dysrhythmias. Despite the heterogeneity in the currently available data, ranolazine appears to be an effective and safe option for the management of various arrhythmias.
心律失常是全球发病和死亡的主要原因之一。虽然抗心律失常药物传统上是一线治疗策略，但其使用常常受到严重促心律失常作用的限制。包括随机对照试验（RCT）在内的多项研究已证明雷诺嗪具有抗心律失常疗效，该药已注册为抗心绞痛药物，同时也确定了其安全性。本综述汇编了研究雷诺嗪抗心律失常特性的临床证据，主要关注室性心动过速（VT）和心房颤动（AF），因为它们是常见的节律异常且伴有严重并发症。随机对照试验的数据表明，雷诺嗪可降低室性心动过速的发生率，尽管这种效果并不普遍。因此，我们试图更好地描述因室性心动过速受抑制而从雷诺嗪中获益最大的患者群体。此外，已知雷诺嗪与胺碘酮等其他抗心律失常药物联合使用时，可提高心房颤动转复为窦性心律的转化率，突出了其在心房中的协同作用而不会引发室性心律失常。尽管现有数据存在异质性，但雷诺嗪似乎是治疗各种心律失常的有效且安全的选择。
