Effect of Ranolazine on Valvular Disease in Patients With Pacemakers

Inclusion Criteria: * Ischemic cardiomyopathy AND * Moderate or severe mitral regurgitation AND * Cardiac resynchronization therapy (CRT) ≥ 3 months prior to enrollment AND * Maximal Medical Therapy (ACE-Inhibitor, beta blocker, aldosterone antagonist, diuretic, aspirin, statin) Exclusion Criteria: * nonischemic cardiomyopathy * active heart failure * current ranolazine therapy * congenital heart disease * mechanical valve prostheses * vegetation/endocarditis * significant pulmonary disease * peripheral vascular disease * trivial or mild mitral regurgitation * creatinine clearance \< 30 mL/min * liver cirrhosis * strong inhibitors of CYP3A (including ketoconazole, itraconazole, clarithromycin, nefazodone, nelfinavir, ritonavir, indinavir, and saquinavir) * strong inducers of CYP3A (including rifampin, rifapentine, phenobarbital, phenytoin, carbamazepine and St.John's wort) * Strong P-glycoprotein inhibitors (including cyclosporine, verapamil, and quinidine) * Initial QTc interval ≥ 440msec