MUSTT
Multicenter Unsustained Tachycardia Trial
Hypothesis:
Antiarrhythmic (AA) therapy guided by EP testing can reduce the risk of arrhythmic death and cardiac arrest in patients with: coronary artery disease (CAD), EF ≤ 0.40, and asymptomatic nonsustained VT (>3 beats, <30 sec, rate >100 bpm)
Primary endpoint:
- Arrhythmic death or cardiac arrest
Secondary endpoints:
- Total mortality
- Cardiac mortality
- Spontaneous, sustained VT
Status:
Start: 1989
Completion: March, 1998
Sample size: 704 patients
Published: New England Journal of Medicine, December 1999
Results:
EP-guided Rx with AA therapy reduced arrhythmic death by 27% and overall mortality by 20% compared to non-EP guided therapy patients (p = 0.04):
- The entire mortality benefit was due to the ICD therapy in the EP-guided Rx arm:
- ICDs reduced arrhythmic death by 76% and overall mortality by 60% compared to EP-guided patients
receiving AA drugs (p < 0.001) - ICDs reduced arrhythmic death by 73% and overall mortality by 55% compared to non-EP-guided
therapy patients (p < 0.001)
- ICDs reduced arrhythmic death by 76% and overall mortality by 60% compared to EP-guided patients
References
- Buxton AE. Prevention of sudden death in patients with coronary artery disease: the Multicenter Unsustained Tachycardia Trial (MUSTT). Prog Cardiovasc Dis. 1993;36:215-226.
- Buxton AE. Ongoing risk stratification trials: the primary prevention of sudden death. Control Clin Trials. 1196;1747S-51S.
- Buxton AE, et al. for the Multicenter Unsustained Tachycardia Trial investigators. A randomized study of the prevention of sudden death in patients with coronary artery disease. N Engl J Med. 1999;341:1882-90.
