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March 21, 1991New England Journal of MedicineOpen Access

Mortality and Morbidity in Patients Receiving Encainide, Flecainide, or Placebo

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Why the study?

Does encainide or flecainide reduce mortality in patients with ventricular ectopy after a myocardial infarction?

Population

1498 patients with ventricular ectopy after a myocardial infarction in whom ventricular ectopy could be…

Comparison

Encainide or flecainide vs Placebo

Design

RCT, randomly assigned

Follow-up

mean 10 months

Authors

DEDebra S. EchtJon Peddie ResearchPLPhilip R. LiebsonPreventive CardiologyLML. Brent MitchellWinnipeg Regional Health Authority

Discussion

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Implication

Encainide or flecainide increases arrhythmic and cardiac mortality post-MI; challenges class Ic use for ventricular ectopy suppression.

Structured PICO

Does encainide or flecainide reduce mortality in patients with ventricular ectopy after a myocardial infarction?

P
Population
1498 patients with ventricular ectopy after a myocardial infarction in whom ventricular ectopy could be suppressed with encainide, flecainide, or moricizine
I
Intervention
Encainide or flecainide
C
Comparator
Placebo
O
Outcome
Mortality (death from arrhythmia, nonarrhythmic cardiac causes, and noncardiac causes)hard clinical

Treatment with encainide or flecainide to suppress ventricular ectopy after myocardial infarction resulted in an excess of deaths due to arrhythmia and nonarrhythmic cardiac causes compared to placebo.

Cite This Study

Echt et al. (1991) studied this question.

synapsesocial.com/papers/6a7ca7cf7c12ccfc2577102dhttps://doi.org/10.1056/nejm199103213241201

Topics

Heart failureHFrEF treatment
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Also Consider

Synapse has enriched 2 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Prophylactic antiarrhythmic therapy of high-risk survivors of myocardial infarction: lower mortality at 1 month but not at 1 year.1987 · 69 citations
  2. 2The Cardiac Arrhythmia Suppression Trial (CAST)1989 · 234 citations