Simopoulos V, et al. - In patients without heart failure (HF), ranolazine (RAN) added to amiodarone (AMIO) has shown efficacy in accelerating termination of postoperative atrial fibrillation (POAF) after coronary artery bypass surgery, so researchers compared the effectiveness of AMIO monotherapy or AMIO+RAN in combination between patients with concomitant HF with reduced (HFrEF) or preserved (HFpEF) ejection fraction. They enrolled 511 patients with POAF and HFrEF (446 males; 65 ± 9 years) and 311 patients with POAF and HFpEF (257 males; 66 ± 10 years) and randomized patients in each group to either AMIO monotherapy (300 mg in 30 min + 1,125 mg in 36 hour IV) or AMIO+RAN combination (500 mg po + 375 mg, after 6 hours and 375 mg twice daily thereafter). Primary endpoint was the time to conversion of POAF within 36 hours following initiation of treatment. They observed a faster conversion of POAF with AMIO alone or AMIO+RAN in patients with reduced ejection fraction vs those with preserved ejection fraction. For terminating POAF in HFrEF patients, AMIO + RAN appeared to be a valuable alternative treatment.