Long-term medical treatment options for atrial fibrillation (AF) include rate-control as well as rhythm-control therapy with various antiarrhythmics. However, because of the limited efficacy and potential side effects of these medications, percutaneous and surgical ablations in AF patients have evolved as alternative or additional approaches to achieve rhythm-control.  Nonetheless, arrhythmia recurrences may also occur after these procedures.  Thus, the search for complementary treatment options continues.

Ranolazine possesses antiarrhythmic effects in atrial myocytes via blockade of sodium channels.  These properties facilitate AF suppression in animal models and human subjects.  We report a patient with persistent AF that was refractory to medical management and percutaneous catheter ablation.  She has remained in sinus rhythm for at least 18 months after the initiation of ranolazine.