Implications of the ESVEM trial for use of antiarrhythmic drugs that prolong cardiac repolarization.
In both the Cardiac Arrhythmia Suppression Trial (CAST) and the Electrophysiologic Study Versus Electrocardiographic Monitoring (ESVEM) trial, class I antiarrhythmic drugs did not appear to perform well, although in the latter trial the class III agent sotalol performed better than 6 class I agents. The results have led some to conclude that class III drugs are now preferred for treatment of ventricular arrhythmias. However, there are a number of reasons why such a conclusion may not be fully justified on the basis of these 2 trials. The data do suggest a need for a critical appraisal and reorientation of drug therapy of life-threatening ventricular arrhythmias.
Mason
J W
JW
Cardiology Division, University of Utah Medical Center, Salt Lake City 84132.
D000818:Animals; D000889:Anti-Arrhythmia Agents / Q000145:classification / Q000494:pharmacology* / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D006329:Heart Conduction System / Q000187:drug effects*; D006801:Humans; D013015:Sotalol / Q000494:pharmacology
D000889:Anti-Arrhythmia Agents; D013015:Sotalol