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August 10, 1989New England Journal of Medicine

The Cardiac Arrhythmia Suppression Trial (CAST)

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Why the study?

Does antiarrhythmic drug therapy reduce the rate of sudden death in patients with asymptomatic or mildly symptomatic ventricular ectopic activity after myocardial infarction?

Population

Patients with asymptomatic or mildly symptomatic ventricular ectopic activity after myocardial infarction

Comparison

Antiarrhythmic drug therapy vs Placebo

Design

Editorial, placebo-controlled

Follow-up

long-term

Authors

JRJeremy N. RuskinElectrophysiology

Discussion

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Implication

Prompts caution against routine ectopy suppression post-MI; leaves open optimal strategies for sudden-death prevention.

Structured PICO

Does antiarrhythmic drug therapy reduce the rate of sudden death in patients with asymptomatic or mildly symptomatic ventricular ectopic activity after myocardial infarction?

P
Population
Patients with asymptomatic or mildly symptomatic ventricular ectopic activity after myocardial infarction
I
Intervention
Antiarrhythmic drug therapy
C
Comparator
Placebo
O
Outcome
Rate of sudden deathhard clinical

The preliminary results of CAST challenge conventional wisdom regarding the suppression of ventricular ectopic activity post-myocardial infarction.

Cite This Study

Jeremy N. Ruskin (1989) studied this question.

synapsesocial.com/papers/6a711d18660549caf2c5bfadhttps://doi.org/10.1056/nejm198908103210608
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Also Consider

Synapse has enriched 4 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Preliminary Report: Effect of Encainide and Flecainide on Mortality in a Randomized Trial of Arrhythmia Suppression after Myocardial Infarction1989 · 3,313 citations
  2. 2Clinical Characteristics of Patients with Ventricular Fibrillation during Antiarrhythmic Drug Therapy1988 · 145 citations
  3. 3Timolol-Induced Reduction in Mortality and Reinfarction in Patients Surviving Acute Myocardial Infarction1981 · 1,677 citations
  4. 4Evaluation of antiarrhythmic drugs on defibrillation energy requirements in dogs. Sodium channel block and action potential prolongation.1989 · 201 citations