ABSTRACT
This chapter summarizes some of the factors relating to the monitoring of antiarrhythmic and cardioactive drugs in the light of the results of the Cardiac Arrhythmia Suppression Trial (CAST). Patients were recruited into CAST if they had asymptomatic or mildly symptomatic ventricular arrhythmia following acute myocardial infarction. The results of CAST should also be seen in the context of the therapeutic alternatives to antiarrhythmic drugs which are now available to clinicians. Mortality following acute myocardial infarction has been reduced by the use of thrombolytic agents, and sudden cardiac death has been reduced by the introduction of implantable defibrillators. The interpretation of drug concentrations may be influenced by such factors as the type of arrhythmia, its spontaneous variability, other drug therapy, other underlying morbidity, and the age of the patient.
