Please login or register to print this page.

Clinical Articles, News & Views

Ranolazine and dronedarone in AF management: the HARMONY trial

Moderate dose ranolazine plus reduced dose dronedarone produces synergistic atrial fibrillation burden (AFB) reduction, with good tolerance/safety, according to results from the HARMONY trial published recently in Circulation: Arrhythmia and Electrophysiology.1

AF requires arrhythmogenic changes in atrial ion channels/receptors and usually altered atrial structure. AF is commonly treated with antiarrhythmic drugs; the most effective block many ion channels/receptors. Modest efficacy, intolerance, and safety concerns limit current antiarrhythmic drugs. The authors hypothesised that combining agents with multiple anti-AF mechanisms at reduced individual drug doses might produce synergistic efficacy plus better tolerance/safety.

HARMONY tested midrange ranolazine (750 mg BID) combined with two reduced dronedarone doses (150 mg BID and 225 mg BID; chosen to reduce dronedarone’s negative inotropic effect) over 12 weeks in 134 patients with paroxysmal AF and implanted pacemakers where AF burden (AFB) could be continuously assessed.

Patients were randomised double-blind to placebo, ranolazine alone (750 mg BID), dronedarone alone (225 mg BID), or one of the combinations. Neither placebo nor either drugs alone significantly reduced AFB. Conversely, ranolazine 750 mg BID/dronedarone 225 mg BID reduced AFB by 59% versus placebo (P=0.008), whereas ranolazine 750 mg BID/dronedarone 150 mg BID reduced AFB by 43% (P=0.072). Both combinations were well tolerated.

References

1. Reiffel JA, Camm AJ, Belardinelli L, et al. Circ Arrhythm Electrophysiol 2015;8:1048–56. http://dx.doi.org/10.1161/CIRCEP.115.002856

Published on: October 30, 2015

Members Area

Log in or Register now.

SEARCH THE SITE

RSS FEED

Subscribe to our RSS feed
home

GET EXCLUSIVE UPDATES

Sign up for our regular email newsletters & be the first to know about fresh articles and site updates.

RECENT COMMENTS

    None Found

ENDORSED BY

  • ArrhythmiaAlliance
  • Stars
  • Anticoagulation Europe
  • Atrial Fibrillation Association
 

You are not logged in

You need to be a member to print this page.
Sign up for free membership, or log in.

You are not logged in

You need to be a member to download PDF's.
Sign up for free membership, or log in.