ABSTRACT
Since the early 1990s, there has been a fundamental change in our approach to antiarrhythmic drug therapy for the symptomatic treatment of tachycardias. Patient safety is now the main factor determining the choice of antiarrhythmic therapy and proarrhythmic risks need to be carefully assessed prior to initiating therapy.19 The Cardiac Arrhythmia Suppression Trials (CAST) randomized recent myocardial infarction survivors with spontaneous and suppressible ventricular ectopy either to therapy with a Class IC drug (flecainide, encainide or moricizine) or to placebo. CAST was stopped prematurely when mortality among patients receiving flecainide or encainide was found to be two-to threefold higher than in patients receiving placebo.1
