Multicenter Unsustained Tachycardia Trial (MUSTT)
Condition: Arrhythmia; Cardiovascular Diseases; Coronary Disease; Death, Sudden, Cardiac; Heart Diseases; Myocardial Ischemia; Tachycardia, Ventricular
MeSH terms: Cardiovascular Diseases; Heart Diseases; Tachycardia; Coronary Disease; Myocardial Ischemia; Tachycardia, Ventricular; Death, Sudden, Cardiac; Ischemia; Death, Sudden
Study type: Interventional
Phase: Phase 3

Summary: 
      To determine the value of electrophysiologic (EP)-guided antiarrhythmic therapy in coronary
      heart disease patients at increased risk for sudden death. The study included a controlled
      clinical trial and a registry.
    

Detailed description: 
      BACKGROUND:

      Cardiac arrest (sudden cardiac death) occurs relatively frequently in asymptomatic patients
      who have had myocardial infarctions, have ejection fractions less than 40 percent, and
      non-sustained ventricular tachycardia. However, it is not possible to predict who will die
      suddenly or when cardiac arrest will occur. Current efforts to reduce sudden death in such
      long-term survivors of myocardial infarction or in patients with coronary disease have
      produced results that are not very encouraging.

      Such patients may feel quite well. They survived their myocardial infarction and may have
      slight or even moderate reduction of exercise ability, but by 'pacing' themselves, such
      patients can lead relatively normal lives. They may be aware of their arrhythmia because of
      short periods of palpitations which may only trouble them transiently. Consequently, this
      group of patients, many still in the prime of their lives, are at relatively high risk of
      dying suddenly.

      The multicenter trial may reveal the most effective treatment for such patients, the value of
      electrophysiologic studies in predicting who is most at risk of sudden cardiac death, and
      whether electrophysiologic studies can help select the best mode of treatment. The protocol
      for performing programmed stimulation and serial drug testing is designed to mirror those
      currently in use by many practicing electrophysiologists.

      DESIGN NARRATIVE:

      Randomized, non-blind. Patients were assigned to standard therapy or to an aggressive arm
      consisting of electrophysiologic-guided antiarrhythmic therapy. Patients in the aggressive
      arm whose ventricular tachycardia was suppressible or who were still inducible, but who were
      hemodynamically stable in ventricular tachycardia, were followed on drug therapy. Otherwise,
      patients in the aggressive arm received an implantable defibrillator. The primary endpoint
      was sudden cardiac death or cardiac arrest. Patients without inducible sustained ventricular
      tachycardia were followed in a registry. Recruitment ceased on October 31, 1996 after a
      recommendation from the DSMB.

      The study completion date listed in this record was obtained from the "End Date" entered in
      the NIH Query View Report (QVR).
    

Intervention name(s): electrophysiology; anti-arrhythmia agents; defibrillators, implantable
Intervention type(s): Procedure; Drug; Device
Intervention MeSH terms: Anti-Arrhythmia Agents
Allocation: Randomized
Primary purpose: Treatment