Author + information
- Received March 23, 1990
- Revision received June 13, 1990
- Accepted June 26, 1990
- Published online December 1, 1990.
- Felix Burkart, MD,
- Matthias Pfisterer, MD, FACC∗,
- Wolfgang Kiowski, MD,
- Ferenc Follath, MD and
- Dieter Burckhardt, MD
- ↵∗Address for reprints: Matthias Pfisterer, MD, Division of Cardiology. Department of Internal Medicine, University Hospital, CH-4031 Basel, Switzerland.
In view of the high risk of sudden cardiac death and the prognostic importance of complex ventricular ectopic activity, the effects of prophylactic antiarrhythmic treatment were investigated prospectively in patients with persisting asymptomatic complex arrhythmias after myocardial infarction. End points were total mortality and arrhythmic events (sudden death, sustained ventricular tachycardia and ventricular fibrillation).
Of 1,220 consecutively screened survivors of myocardial infarction, 312 had Lown class 3 or 4b arrhythmia on 24 h electrocardiographic recordings before hospital discharge and consented to the study. They were randomized to individualized antiarrhythmic treatment (Group l, n = 100), treatment with low dose amiodarone, 200 mg/day (Group 2, n = 98) or no antiarrhythmic therapy (Group J [control group], n = 114).
During the 1 year follow-up period, 10 patients in Group 1 died, as did 5 in Group 2 and 15 in Group 3. On the basis of an intention to treat analysis, the probability of survival of patients given amiodarone was significantly greater than that of control patients (p < 0.05). In addition, arrhythmic events were significantly reduced by amiodarone (p < 0.01). These effects were less marked and not significant for individually treated patients (Group 1). These findings suggest that low dose amiodarone decreases mortality in the 1st year after myocardial infarction in patients at high risk of sudden death.
with the Technical Assistance of Hanka Jordi
☆ This study was presented in part at the 62nd Annual Scientific Session of the American Heart Association, New Orleans, Louisiana, November 1989. It was supported by Grants 3.966-0.80 and 3.889-0.83 from the Swiss National Foundation for Scientific Research, Berne, Switzerland.
- Received March 23, 1990.
- Revision received June 13, 1990.
- Accepted June 26, 1990.