Meta-analysis of empirical long-term antiarrhythmic therapy after myocardial infarction

SUDDEN cardiac death remains a major cause of mortality and a significant public health concern. At least 40% of sudden deaths occur in people with clinically overt heart disease, and among patients with coronary heart disease, the risk of sudden death is relatively greater for those patients who have had a myocardial infarction (MI) than for those who have not.¹Approximately 50% of MI-related deaths are sudden and usually caused by ventricular arrhythmias.²,³Although the majority of these deaths occur in the earliest phases of MI,⁴the risk of mortality beyond 1 year after MI remains four to eight times greater than that for comparable patients who did not have an MI.⁵,⁶Approximately 35% to 40% of deaths that occur late after MI will be caused by sudden death.⁷ The presence of premature ventricular contractions (PVCs) after MI has been shown to be a risk