Mortality

• Moricizine was one the the three antiarrhythmic drugs included in the National Heart Lung and Blood Institute's (NHLBI) Cardiac Arrhythmia Suppression Trial (CAST), a long-term, multi-center, randomized, double blinded study in patients with asymptomatic non-life threatening ventricular arrhythmias who had had a myocardial infarction more than six days but less than two years previously. An excessive mortality or non fatal cardiac arrest rate was seen in patients treated with both of the class 1Q agents included in the trial which led to discontinuation of those two arms of the trial. The average duration of treatment with these agents was 10 months.
• The moricizine and placebo arms of the trial were confirmed in the NHLBI sponsored CAST II. In this randomized, double-blind trial, patients with asymptomatic non-life threatening ventricular arrhythmias who had had a myocardial infarction within 4 to 90 days and left ventricular ejection fraction < 0>
• The applicability of the CAST results to other populations (e.g. those without recent myocardial infarction) is uncertain. Considering the known proarrhtymic properties of moricizine and the lack of evidence of improved survival for any antiarrhythmic drug in patients without life-threatening arrhythmias, the use of moricizine as well as other anti-arrhythmic agents should be reserved for patients with life-threatening ventricular arrhythmias.