Comparative Review Between Ranolazine and Amiodarone as an Antidysrhythmic Drugs

Aljuofi FA, Hendawy OM*

Dysrhythmia can be life threatening and results in stroke or heart failure if untreated. Up to 65% of patients had sudden cardiac death as first manifestation of cardiac dysrhythmia. In the United States, more than 850,000 people are hospitalized for dysrhythmia each year. Cardiac dysrhythmias could occur in up to 25% of patients treated with digitalis, 50% of anaesthetized patients and over 80% of patients of myocardial infarction. Cardiac ischemia increases the activity of late sodium entry (INa) that results in higher intracellular sodium with subsequent calcium overload through interference with sodium-calcium exchange. Increased intracellular calcium triggers cardiac dysrhythmia. Amiodarone is a powerful antidysrhythmic medication for supra-ventricular and ventricular arrhythmias. A majority of patients treated withamiodarone suffer from mild adverse events, however, serious life-threatening adverse effects caused by amiodarone are also seen, for the serious complications caused by Amiodarone treatment, this review asses antidysrhythmic effects of Amiodarone compared to that exerted by Ranolazine. Ranolazine is an anti-anginal drug that selectively inhibits late INa 10-fold more than peak INa. Blocking of late sodium channels during phase 3 of cardiac action potential leads to a decrease in late sodium entry with subsequent decrease in intracellular calcium, which will probably improve ischemia and may have antidysrhythmic potential