The Cardiac Arrhythmia Suppression Trial (CAST)

Abstract

The Cardiac Arrhythmia Suppression Trial (CAST) was designed to examine the hypothesis that suppressing asymptomatic or mildly symptomatic ventricular ectopic activity after myocardial infarction would reduce the rate of sudden death. CAST, which was preceded by a well-designed feasibility study, the Cardiac Arrhythmia Pilot Study,¹ is the first long-term, multicenter, multidrug, placebo-controlled trial of the safety and efficacy of antiarrhythmic drug therapy in reducing the risk of sudden death.² The preliminary results, as presented in the media and in expanded form in this issue of the Journal^,2 have astounded most observers and challenge much of the conventional wisdom about . . .