Mortality and Morbidity in Patients Receiving Encainide, Flecainide, or Placebo: The Cardiac Arrhythmia Suppression Trial

VENTRICULAR premature depolarizations are a risk factor for sudden and nonsudden cardiac death after myocardial infarction 1 and are often treated with antiarrhythmic drugs. 2 Ventricular arrhythmia and left ventricular dysfunction have been found to be independent predictors of cardiac mortality, 3 with more than 10 ventricular premature depolarizations per hour (detected by ambulatory monitoring) associated with a fourfold higher mortality rate. 4 Previous studies have failed to demonstrate that antiarrhythmic therapy reduces the long-term risk of sudden death. 5 6 7 8 9 10 11 12 13 14 15 The Cardiac Arrhythmia Suppression Trial (CAST), a multicenter, randomized, placebo-controlled study, was designed to test whether the suppression of asymptomatic or mildly symptomatic ventricular arrhythmias . . .