The aim of the study was to establish the effectiveness of combined pharmacotherapy of angina pectoris in patients with heart arrhythmia using ranolazine. Materials and methods. We conducted an open prospective study of 17 patients with coronary artery disease, stable angina pectoris of III–IV functional class. The effectiveness of the therapy was assessed using a survey and a clinical examination after six months of treatment. Results. At the end of the first month, anginal attacks were not observed in all patients with angina pectoris of III functional class and in 50% of patients with angina pectoris of IV functional class. The same results were obtained during the survey of patients at the end of 6 months of observation. Atrial and ventricular extrasystoles were not observed at the end of the first month in 5 of 9 patients with such rhythm disturbances. At the end of three months of observation, none of the patients noted heart arrhythmia. Conclusion. Ranolazine is an effective component of antianginal therapy, which significantly improves the patient’s quality of life. The use of ranolazine can be effective in patients with angina accompanied by ventricular and atrial arrhythmia, as it is an anti-anginal drug with proven anti-ischemic and metabolic, as well as anti-arrhythmic effects.