3/8/99 - PRNewswire - Results from the Multicenter Unsustained Tachycardia Trial (MUSTT) show that when an electrophysiologist (cardiologist who specializes in heart rhythm) uses electrophysiology (EP) testing to guide therapy in high risk patients, arrhythmic death is reduced by 27%.
	Also, when this group was treated with an ICD, the risk of arrhythmic death was reduced by more than 50% when compared to those patients who did not receive ICD therapy. 300,000 - 400,000 people in the USA die from sudden cardiac death each year.
	"The preliminary results of MUSTT show a need for EP-guided therapy for high risk patients with coronary artery disease which. This can reduce the number of sudden cardiac deaths in these patients," said Alfred Buxton, MD, Temple University School of Medicine, lead investigator for MUSTT. "The study has defined the risk for sudden death in this study population, which was found to be 32% at 5 years."
	One of the most tightly-controlled studies of its kind, the MUSTT trial included patients from 85 medical centers in the USA and Canada. 2,200 patients with a history of coronary artery disease, depressed left ventricular function and spontaneous non-sustained ventricular tachycardia were studied. This group was considered to be at high risk for sudden cardiac death. Patients had an electrophysiologic study (EPS), a test that records electrical signals from the heart to identify a tendency for arrhythmia and were then assigned to one of 2 groups.
	Study patients who did not show sustained ventricular tachycardia during EPS did not get anti-arrhythmic therapy. Patients who did show sustained ventricular tachycardia were assigned randomly to either no anti-arrhythmic therapy or to a FDA-approved anti-arrhythmic drug. An EPS was then done to test the effectiveness of the drug. If the drug therapy failed, patients could receive either an ICD or a different anti-arrhythmic drug.
	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 did not increase survival in these patients. MUSTT has shown that ICD therapy can be effective for preventing sudden cardiac death and in some patients, may be considered first-line therapy.
	ICDs, the size of a small pager, bring the technology of external defibrillators used in emergency rooms right into a patient's chest. Once in place, an ICD constantly monitors the heart's rhythm and automatically delivers the appropriate shock to stop a life-threatening arrhythmia and restore the heart to a normal rhythm.

Title: NIH-Sponsored Trial Shows Electrophysiology-Guided Therapy Reduces the Incidence of Sudden Cardiac Death by 27 Percent
From: 48th annual American College of Cardiology (ACC) Scientific Sessions