MUSTT is out!
<Late-Breaking Data at ACC Also Reveals a Reduction in the Rate of SuddenCardiac Death by Greater Than 50 Percent in the Treatment Group that Received ICD Therapy
March 8, 1999 12:45 PM
NEW ORLEANS, March 8 /PRNewswire/ -- A large prospective multicenter study presented today at the 48th annual American College of Cardiology (ACC) Scientific Sessions provides compelling evidence to support the significant role that electrophysiologists and implantable cardioverter-defibrillators (ICDs) can play in reducing sudden cardiac death in certain patients with coronary artery disease.
( Photo: newscom.com ) ( Photo: newscom.com ) ( Photo: newscom.com )
Results from the Multicenter Unsustained Tachycardia Trial (MUSTT) indicate that when an electrophysiologist -- a cardiologist who specializes in the diagnosis and treatment of heart rhythm disorders -- uses electrophysiology (EP) testing to guide therapy in high risk coronary patients, arrhythmic death is reduced by 27 percent. Additionally, when this group was treated with an ICD, the risk of arrhythmic death was reduced by greater than 50 percent when compared to those patients who did not receive ICD therapy. Currently, 300,000 - 400,000 people in the United States die from sudden cardiac death each year.
"The preliminary results of MUSTT have created a very compelling argument for the early adoption of EP-guided therapy for high risk patients with coronary artery disease which, in turn, can significantly reduce the number of sudden cardiac deaths in this patient population," said Alfred E. Buxton, M.D., Department of Medicine at Temple University School of Medicine, Philadelphia and lead clinical investigator of MUSTT. "The study has clarified the risk for sudden death in this study population, which was found to be 32 percent at five years."
One of the most tightly-controlled studies of its kind, the MUSTT trial included patients from a total of 85 medical centers in the U.S. and Canada. More than 2,200 patients with a history of coronary artery disease, depressed left ventricular function and spontaneous non-sustained ventricular tachycardia were evaluated. This group was considered to be at a substantial risk for sudden cardiac death. Patients then underwent an electrophysiologic study (EPS), a test that records electrical signals from the heart to identify a predisposition for life-threatening arrhythmias, before being randomized into two groups.
Study patients who did not exhibit sustained ventricular tachycardia during electrophysiologic testing did not receive anti-arrhythmic therapy. The patients who did experience sustained ventricular tachycardia during this test were assigned randomly to no anti-arrhythmic therapy or to a FDA-approved anti-arrhythmic drug. An EPS was then conducted to assess the efficacy of the drug. If the initial drug therapy failed, patients could receive either an ICD or a different anti-arrhythmic drug.
According to Dr. Buxton, previous studies have suggested that EPS could identify patients at high risk for sudden cardiac death. While previous studies have suggested that drugs are the first-line therapy for patients with coronary artery disease, drugs conferred no survival benefit in this population. MUSTT has shown that ICD therapy can be an effective means of preventing sudden cardiac death and in some patient populations, should be considered a first-line therapy.
ICDs, which are approximately the size of a small pager, bring the technology of external defibrillators used in emergency rooms across the country right into a patient's chest. Once in place, an ICD constantly monitors the heart's rhythm and automatically delivers the appropriate electrical therapy to interrupt a life-threatening arrhythmia and restore the heart to a normal rhythm.
SOURCE Medtronic, Inc.>
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