Clinical Trials of Antiarrhythmic Drugs in Postmyocardial Infarction and Congestive Heart Failure Patients

Sudden cardiac death (SCD) is defined as instanta-neous, unexpected death or death within 1 hour of symptom onset not related to circulatory failure. It accounts for 300,000 deaths in the U.S. annually (1). The majority of SCD are due to ventricular tachycar-dia or ventricular fibrillation. Although some SCD victims have no overt evidence of cardiovascular dis-ease, patients with existing heart disease are at far greater risk. Many cardiac diseases, especially myocardial infarction (MI) and congestive heart fail-ure (CHF), increase the risk of ventricular tachy-arrhythmias and SCD. Recognition of the relatively high rate of arrhythmic death in patients with MI or CHF has prompted the search for effective, prophy-lactic antiarrhythmic drug treatment. Antiarrhythmic agents from all four Vaughan Williams classes have been evaluated