In treatment of chronic angina pectoris in the last few years, besides the medicines with antianginal effect (adrenergic receptor beta blockers, calcium antagonists and nitrates) even ranolazine may be applied. This innovative drug having effect on pathological process that occurs at a very early stage of ischemia, may block harmful effects that occur in cascade process. Ranolazine is the first antianginal metabolic modulator that has appeared in the last 25 years of treatment of angina pectoris, having inhibition effect on sarkoplasmatic late Na channels with no significant effect on heart rate and blood pressure as well as respiratory tract. Apart from proved antianginal effect, ranolazine represents a new possibility of treatment of heart diseases associated with impaired homeostasis of myocardial ions, especially in patients with impaired homeostasis of Na ions as it occurs in heart failure. The inhibition of late Na channels may be a new antiarrhythmic approach to supraventricular and ventricular arrhythmias (tachycardias), while potential studies of heart failure with systolic and/or diastolic dysfunction and atrial fibrillation represent the future of research of potential benefit of application of ranolazine.