Antagonism by ranolazine of the pro-arrhythmic effects of increasing late INa in guinea pig ventricular myocytes.

Abstract:

:The new anti-anginal drug ranolazine causes a slight (<10 milliseconds) prolongation of the QT interval, raising the concern that its use may be associated with an increased incidence of torsades de pointes ventricular tachyarrhythmias. The goal of this study was to show that ranolazine inhibits the late component of INa and attenuates prolongation of action potential duration when late INa is increased, both in the absence and presence of IK-blocking drugs. Currents and action potentials of guinea pig isolated ventricular myocytes were measured by whole-cell patch clamp. Sea anemone toxin (ATX)-II was used to increase late INa and mimic the effect of an SCN5A gene mutation. ATX-II (3-5 nmol/L) increased late INa by 5-fold; ranolazine attenuated this increase of late INa by up to 61 +/- 8%. ATX-II (10-20 nmol/L) increased action potential duration (APD) by > 1 seconds, and caused early afterdepolarizations; both actions were attenuated by ranolazine (0.1-30 micromol/L). Ranolazine (10 micromol/L) reduced by 89% the 13.6-fold increase in variability of APD caused by 10 nmol/L ATX-II. The effects of ATX-II (3 nmol/L) in combinations with either the IKr blocker E-4031 or the IKs blocker chromanol 293B to increase APD were attenuated 76 +/- 5% and 71 +/- 4%, respectively, by 10 micromol/L ranolazine. The results demonstrate that ranolazine reduces late INa and has an anti-arrhythmic effect when late INa is increased.

journal_name

J Cardiovasc Pharmacol

authors

Song Y,Shryock JC,Wu L,Belardinelli L

doi

10.1097/00005344-200408000-00008

subject

Has Abstract

pub_date

2004-08-01 00:00:00

pages

192-9

issue

2

eissn

0160-2446

issn

1533-4023

pii

00005344-200408000-00008

journal_volume

44

pub_type

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