Congestive heart failure after acute myocardial infarction in patients receiving antiarrhythmic agents for ventricular premature complexes (Cardiac Arrhythmia Pilot Study).
The Cardiac Arrhythmia Pilot Study (CAPS) was a randomized, double-blind trial of antiarrhythmic drugs (encainide, flecainide, moricizine, imipramine and placebo) in 502 patients with an ejection fraction greater than 0.20 and at least 10 ventricular premature complexes/hour, 6 to 60 days after acute myocardial infarction. Patients were followed for 1 year and the incidence of new or worsened congestive heart failure (CHF) was evaluated. Heart failure in the 1-year follow-up was gauged by the development (in order of increasing severity) of new symptoms (grade 1), the need for a change in therapy, including addition of digitalis, addition or increase of dose of diuretics or afterload reduction agents or discontinuation of beta-blocking agents (grade 2), or by hospitalization (grade 3). Sixty-one of 502 patients (12%) required hospitalization for CHF in the 1-year follow-up. One hundred five of 403 patients (26%) in the active treatment group and 18 of 99 patients (18%) in the placebo group (difference not significant) developed CHF requiring hospitalization or a change in therapy or both. Although patients with severely impaired ejection fraction were excluded, new or worsened CHF was common in follow-up during CAPS.
Greene
H L
HL
CAPS Coordinating Center, University of Washington, Seattle 98105.
Richardson
D W
DW
Hallstrom
A P
AP
McBride
R
R
Capone
R J
RJ
Barker
A H
AH
Roden
D M
DM
Echt
D S
DS
D000813:Anilides / Q000009:adverse effects; D000889:Anti-Arrhythmia Agents / Q000009:adverse effects*; D005117:Cardiac Complexes, Premature / Q000188:drug therapy / Q000209:etiology; D004311:Double-Blind Method; D016700:Encainide; D005260:Female; D005424:Flecainide / Q000009:adverse effects; D006333:Heart Failure / Q000139:chemically induced / Q000209:etiology* / Q000401:mortality; D006801:Humans; D007099:Imipramine / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D016293:Moricizine; D009203:Myocardial Infarction / Q000150:complications*; D010640:Phenothiazines / Q000009:adverse effects; D011897:Random Allocation; D013318:Stroke Volume / Q000187:drug effects
D000813:Anilides; D000889:Anti-Arrhythmia Agents; D010640:Phenothiazines; D016293:Moricizine; D005424:Flecainide; D007099:Imipramine; D016700:Encainide