NPPB and atrial fibrillation: Some recent studies have shown that levosimendan increases cerebral blood flow, decreases NT-proBNP (an indirect marker of adverse atrial remodeling), and improves atrial pump function on echocardiography; however, it also increases the occurrence of AF in these patients, an undesired effect attenuated by concomitant treatment with ranolazine, an inhibitor of the late inward sodium current [55].