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(Circulation. 2007;116:1643.)
© 2007 American Heart Association, Inc.

Issue Highlights

An extract of the first 250 words of the full text is provided, because this article has no abstract.

EFFECT OF RANOLAZINE, AN ANTIANGINAL AGENT WITH NOVEL ELECTROPHYSIOLOGICAL PROPERTIES, ON THE INCIDENCE OF ARRHYTHMIAS IN PATIENTS WITH NON–ST-SEGMENT–ELEVATION ACUTE CORONARY SYNDROME: RESULTS FROM THE METABOLIC EFFICIENCY WITH RANOLAZINE FOR LESS ISCHEMIA IN NON–ST-ELEVATION ACUTE CORONARY SYNDROME–THROMBOLYSIS IN MYOCARDIAL INFARCTION 36 (MERLIN-TIMI 36) RANDOMIZED CONTROLLED TRIAL, by Scirica et al.

 
Ranolazine is an inhibitor of the late phase of the inward sodium current during cardiac repolarization. It has been shown to reduce myocardial ischemia. However, ranolazine prolongs the QTc by 2 to 6 ms. This has raised concerns about the possibility that this may reflect increased susceptibility to arrhythmias. However, this QTc prolongation is not associated with other changes, and in animal studies, ranolazine has been shown to suppress arrhythmic activity. In the MERLIN-TIMI 36 trial, ranolazine was associated with a decrease in arrhythmias. In this issue of Circulation, Scirica et al report the findings of a substudy of the MERLIN-TIMI 36 trial in 97% of randomized patients (n=6351) who had continuous ECG recordings. Treatment with ranolazine resulted in fewer patients having ventricular tachycardia, regardless of whether ischemia was present (5.3% versus 8.3%; P<0.001). Supraventricular tachycardia and ventricular pauses were also less frequent. These findings are exploratory but indicate that ranolazine has direct antiarrhythmic effects. See p 1647.

	USE OF CARDIAC REHABILITATION BY MEDICARE BENEFICIARIES AFTER MYOCARDIAL INFARCTION OR CORONARY BYPASS SURGERY, by Suaya et al.

 
Outpatient cardiac rehabilitation is an efficient and important venue where secondary prevention interventions are implemented and reinforced. Cardiac rehabilitation has been shown to improve exercise capacity, risk factor profile, and quality of life and appears to confer a lower risk of total and cardiovascular mortality among participants. Accordingly, the American College of Cardiology and the American Heart Association strongly recommend cardiac rehabilitation for those patients who are capable of participating after acute myocardial infarction, acute coronary syndromes, and coronary artery bypass surgery. In this issue of Circulation, Suaya . . . [Full Text of this Article]

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