6/28/23, 11:19 PM MUSTT Pathway Feedback Search Clinical Topics Home Studies MUSTT MUSTT Disease Ventricular arrhythmias Trial question Is antiarrhythmic therapy superior to no antiarrhythmic therapy in patients with coronary artery disease, a LVEF of 40%, and asymptomatic, unsustained VT in whom sustained ventricular tachyarrhythmias were induced by programmed stimulation? Study design Multi-center Single blinded RCT Population Characteristics of study participants 10.0% female N = 704 90.0% male 704 patients (70 female, 634 male) Inclusion criteria: patients with coronary artery disease, an LVEF of 40%, and asymptomatic, unsustained VT in whom sustained ventricular tachyarrhythmias were induced by programmed stimuation Key exclusion criteria: history of syncope, or sustained VT or fibrillation > 48 hours after the onset of acute myocardial infarction; systemic disease likely to be fatal in < 2 years; and 80 years of age Interventions https://web.pathway.md/studies/recCG76B5pLwWrnHB 1/2 6/28/23, 11:19 PM MUSTT Pathway N=351 antiarrhythmic therapy (drugs and implantable defibrillators, as indicated by the results of electrophysiologic testing) N=353 no antiarrhythmic therapy (electrophysiologic testing without antiarrhythmic therapy) Primary outcome Cardiac arrest or death from arrhythmia 32.0 % 32 25 24.0 % 16.0 % Significant decrease 8.0 % NNT = 14 0.0 % Antiarrhythmic therapy No antiarrhythmic therapy Significant decrease in cardiac arrest or death from arrhythmia (25% vs. 32%; RR 0.73, 95% CI 0.53 to 0.99) Secondary outcomes No significant difference in death at 5 years (42% vs. 48%; RR 0.8, 95% CI 0.64 to 1.01) Significant decrease in cardiac arrest or death from arrhythmia (12 vs. 56; RR 0.24, 95% CI 0.13 to 0.45) Conclusion In patients with coronary artery disease, an LVEF of 40%, and asymptomatic, unsustained VT in whom sustained ventricular tachyarrhythmias were induced by programmed stimuation, antiarrhythmic therapy was superior to no antiarrhythmic therapy with respect to cardiac arrest or death from arrhythmia. Reference Buxton AE, Lee KL, Fisher JD et al. A randomized study of the prevention of sudden death in patients with coronary artery disease. Multicenter Unsustained Tachycardia Trial Investigators. N Engl J Med. 1999 Dec 16;341(25):1882-90. Open reference URL https://web.pathway.md/studies/recCG76B5pLwWrnHB 2/2