The classification of 'sudden arrhythmic death' in patients on antiarrhythmic therapy is often problematic and subject to interpretation, highlighting the reliability of total mortality and total cardiac mortality as endpoints.
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Ambiguous sudden arrhythmic death classification warrants caution in endpoint adjudication; supports total mortality as more reliable in observational antiarrhythmic studies.
In the evaluation of antiarrhythmic treatment, total mortality and total cardiac mortality are the only endpoints difficult to misclassify. End-stage cardiac failure competes with "suddenness" in many instances of sudden arrhythmic death. This observational study reports on 23 deaths in a group of 129 patients under antiarrhythmic treatment. In the 21 cases of cardiac death, with respect to the notion "sudden arrhythmic death," classification was problematic in 6 patients. According to different interpretations, the number of deaths listed as "sudden" could vary between one and six. A concise description of cause and circumstances of death, is presented.
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Ector et al. (1993) studied this question.
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