PRELIMINARY-RESULTS OF THE CARDIAC-ARREST STUDY HAMBURG (CASH)

Sodium channel blockers and class III antiarrhythmic compounds, as wel l as beta blockers, have been used in preventing recurrences of sudden cardiac death. In recent years, implantable cardioverter-defibrillato rs (ICDs) have been used increasingly, but no data from randomized tri als comparing antiarrhythmic drug and ICD therapy have been reported i n this setting. In 1987, the Cardiac Arrest Study Hamburg (CASH), a pr ospective, randomized trial, was initiated to compare metoprolol, amio darone, propafenone, and ICD implantation in patients surviving sudden cardiac death due to documented ventricular tachycardia and/or ventri cular fibrillation. The details of the study design and preliminary re sults are presented herein. The primary endpoint of the study is total mortality. The data reviewed in March 1992, representing a mean follo w-up period of 11 months, indicated no significant differences among p atients randomized to metoprolol, amiodarone, and ICDs. However, there was a significantly higher total mortality and cardiac arrest recurre nce in patients randomized to propafenone compared with those randomiz ed to the ICD treatment limb. The study continues with the deletion of the propafenone treatment limb.